Participation in Personal and Professional Roles After Young Adult Stroke: A Scoping Review

Abstract

Importance Young adulthood is characterized by role developmental and occupational transitions; however, rehabilitation for young adult stroke survivors (YASS) is largely informed by evidence from older adults. Understanding the unique participation challenges of YASS is important for identifying tailored intervention targets. Objective To systematically map, synthesize, and identify gaps in the literature examining YASS participation. Data Sources EBSCO search across Academic Search Ultimate, CINAHL Plus with Full Text, MEDLINE, and APA PsycInfo. Study Selection and Data Collection Peer-reviewed studies reporting original data from YASS aged 18–45 that address participation in a role (e.g., parent, spouse), activity (e.g., education), or set of activities (e.g., activities of daily living). Data were extracted and synthesized to describe poststroke participation. Findings Fifteen studies reflected a heterogeneous evidence base. Findings suggest that stroke leads to occupational disruption with multi-layered and compounding effects on roles and activities during young adulthood. Conclusions and Relevance Stroke disrupts the life course trajectory through which roles, identities, future possibilities, and life structures are formed, negotiated, and adjusted. This review charted the limited and fragmented literature, indicating a need for evidence to inform clinical practices tailored to the distinct and evolving needs of YASS. Plain-Language Summary Stroke is becoming more common in young adults, but little is known about how stroke affects participation in important roles and occupations of young adulthood, like building relationships and developing a career. Fifteen studies examined how stroke affects young adults’ participation. These studies showed that stroke disrupts not just specific roles and activities but the entire process of building an adult life, affecting personal relationships, career plans, and identity formation. Currently, stroke rehabilitation primarily focuses on motor recovery, self-care, and mobility, but may not address the unique and changing needs of young adults as they form their adult life. The findings of this review suggest that rehabilitation for young adult stroke survivors should address developmentally important roles like intimate relationships, parenting, education, and career development. More research is needed to guide care tailored to young adult stroke survivors’ unique needs.