# LATENT PROFILE ANALYSIS OF SOCIAL PARTICIPATION IN STROKE SURVIVORS WITH LIMB DYSFUNCTION: A MIXED-METHODS STUDY

## TL;DR

This study identifies four distinct patterns of social participation among stroke survivors with limb dysfunction, influenced by physical function, age, resilience, and emotional outlook.

## Contribution

The study introduces a person-centered framework for understanding post-stroke social participation through integrated quantitative and qualitative methods.

## Key findings

- Four social participation profiles were identified: Active Integration, Contented Conservatism, Cautious Conservatism, and Alienated Disengagement.
- Age, resilience, and physical function were significant predictors of profile membership.
- Emotional experiences of loss or rebuilding and behavioral patterns explained the profiles' characteristics.

## Abstract

This study aimed to identify profiles of social participation among stroke survivors with limb dysfunction and explore the factors influencing these profiles.

A convergent mixed-methods design.

The quantitative phase involved 499 participants recruited from 5 neurorehabilitation centres in Shanghai between December 2023 and June 2025. Participants completed measures including the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Modified Rankin Scale (mRS). Qualitative semi-structured interviews were performed with 16 participants to explore lived experiences of social participation.

Latent profile analysis revealed 4 distinct social participation profiles: “Active Integration”, “Contented Conservatism”, “Cautious Conservatism”, and “Alienated Disengagement”. A multivariate analysis identified age, resilience, and physical function as significant predictors of profile membership. Qualitative findings uncovered 2 core emotional experiences (a sense of loss vs a sense of rebuilding) and 3 behavioural patterns (activist, conservative, alienated), which effectively explained the quantitative profiles’ characteristics and their underlying mechanisms. The integration of data provided a nuanced person-centred framework depicting the heterogeneity in post-stroke social participation.

Social participation among stroke survivors is heterogeneous and can be classified into 4 distinct profiles shaped by the interplay of physical function, resilience, and sociodemographic factors. The findings underscore the necessity of implementing profile-specific, stepped-care interventions for effectively enhancing post-stroke social participation.

Stroke often causes extremity disability, significantly impacting survivors’ ability to engage in social activities. This study aimed to understand the different ways stroke survivors participated in society. We surveyed 499 stroke survivors and interviewed 16 others. We identified 4 distinct patterns: “Active Integration” (actively engaged), “Contented Conservatism” (less active but satisfied), “Cautious Conservatism” (less active and dissatisfied), and “Alienated Disengagement” (largely withdrawn). The pattern a stroke survivor fell into was influenced not just by physical function but also by age, psychological resilience, and emotional outlook – particularly whether they focused on loss or on rebuilding their life after stroke. These findings highlight that personalized support plans, tailored to an individual’s specific needs and mindset, are crucial for effectively helping stroke survivors regain social connection and improve their quality of life.