STROke, Life and LeisurE Research Survey (STROLLERS)
Research type
Research Study
Full title
STROke, Life and LeisurE Research Survey (STROLLERS)
IRAS ID
220494
Contact name
Caroline Watkins
Contact email
Sponsor organisation
The University of Central Lancashire
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Research Summary
Stroke is a major cause of death and disability worldwide. In the UK, there are over 1.2 million people living with the consequences of a stroke. Post-stroke impairments have a profound impact on quality of life after stroke, with around two thirds of stroke survivors reporting reduced participation in pre-stroke valued leisure activities. Although the importance of return to pre-stroke valued activities is recognised in national clinical guidelines for stroke, there is evidence to suggest that the focus of stroke rehabilitation remains oriented towards recovery of physical function (e.g. improving activities of daily living (ADLs) and mobility), rather than supporting individuals to return to previously valued social and leisure activities.
The aim of this study is to examine changes in leisure participation after stroke. People experiencing a new first or recurrent transient ischaemic attack (TIA) or stroke will be invited to take part in the study whilst an in-patient, or at a first post event TIA clinic appointment. Consenting patients will be asked to complete two questionnaires (i) a baseline questionnaire to gather data on frequency of participation in leisure activities in the few weeks prior to their stroke and (ii) a six month follow-up questionnaire to gather data on frequency of participation in leisure activities in the few weeks prior to completion of the questionnaire. The Shortened Nottingham Leisure Questionnaire is the primary measure for the study. A sub-sample of consenting participants, who return both baseline and follow-up questionnaires, will be invited to take part in a telephone interview to discuss in greater detail their responses in the questionnaires. Maximum variation sampling will be employed to ensure that a range of experiences of return to leisure for people after stroke are represented.Summary of Results
The STROLLERS study recruited 3295 eligible participants; 2000 participants returned questionnaires at follow-up. Data showed three participant variables predicted engagement in leisure activities post-stroke/TIA: age, sex, and socioeconomic area. There was an overall decline in the number and variety of leisure activities, with an average loss of 2.2 activities following stroke/TIA. Only one activity, "exercise/fitness" saw an increase in engagement from baseline to follow-up; watching TV remained stable, whilst participation in all other activities reduced between 10% and 40% with an average activity engagement reduction of 22%.
The open-text questions resulted in twelve themes. The percentage (%) of respondents reporting each is given in brackets. Barriers: physical difficulties (69%), lower energy levels (17%), loss of independence (11%), psychological difficulties (10%), hidden disabilities (7%), and delay or lack of healthcare provision (3%). Facilitators: family support (35%), healthcare support (27%), well-being and fitness (22%), friendship support (20%), self-management (19%), and returning to normality (9%). 'Physical difficulties' was the most reported barrier across all participant characteristics and activity types. Family support was the most reported facilitator except for those with greater disability, where it was healthcare support and those without fatigue where it was well-being and exercise.Conclusions: Some groups experienced a greater reduction in activities than others-notably older participants, female participants, and those living in a low socioeconomic area. Physical difficulties and lack of energy are problematic for stroke and TIA survivors who want to return to or participate in leisure activity. Healthcare support alone cannot overcome all practical and emotional issues related to leisure activity engagement. Family support and improving well-being are important facilitators and future research should explore these mechanisms further.
REC name
Wales REC 5
REC reference
17/WA/0336
Date of REC Opinion
25 Oct 2017
REC opinion
Favourable Opinion