Associations of motor recovery and perceived social support with participation-related outcomes in chronic stroke

Background Participation after stroke is shaped by motor recovery and contextual factors within the ICF framework. Although social support is considered an important environmental factor, its association with participation-related health outcomes in chronic stroke remains insufficiently understood.Aims To examine the associations of motor recovery and perceived social support with participation-related outcomes in individuals with chronic stroke and to provide descriptive comparisons with healthy controls.Methods Forty community-dwelling individuals with chronic stroke (≥3 months post-stroke) and 41 age-matched healthy controls completed a single-session assessment. Perceived social support, life satisfaction, and participation-related health-related quality of life were assessed using validated instruments. Forced-entry multivariable linear regression analyses were performed in the stroke group, with age, Multidimensional Scale of Perceived Social Support total score, and Brunnstrom lower extremity stage entered simultaneously into each model.Results Compared with healthy controls, individuals with chronic stroke demonstrated poorer physical functioning (p < .01), role physical(p < .01), general health (p = .002), vitality (p = .003), and social functioning (p = .001), whereas total perceived social support (p = .835) and life satisfaction(p = .736)did not differ. In the stroke group, the regression models for social functioning (R2adj = 0.245) and vitality (R2adj = 0.270) were statistically significant. Higher Brunnstrom lower extremity stage was associated with better social functioning (β = 0.399, p = .007) and vitality (β = 0.438, p = .003), while higher perceived social support was associated only with better vitality (β = 0.288, p = .045).Conclusion Motor recovery and perceived social support showed domain-specific associations with participation-related outcomes in chronic stroke. These findings support a multidimensional interpretation of participation-related health outcomes rather than assuming a uniform role for either functional recovery or social support.