ArticleCommunity ambulation after stroke: how important and obtainable is it and what measures appear predictive?1☆,
Section snippets
Participants
In this multicenter, observational study, stroke survivors from 3 regional hospitals in New Zealand, which serve a combined population of approximately 800,000 people, were recruited between July 2000 and February 2002. The inclusion criteria were people who presented with a first-ever or recurrent stroke (MONICA definition)14 and who had been ambulant in the community before their stroke. The participants were a convenient sample of people who had been discharged home after inpatient
Sample characteristics
A total of 130 people with stroke participated in the study: 50 subjects from each of 2 centers and 30 subjects from the third center. Based on the findings of a community-based study of stroke in Auckland, New Zealand, this figure is likely to represent about one third of stroke survivors who present with a moderate or severe motor deficit 1 month after stroke and who live at home.19Table 1 describes the characteristics of the total sample and the amount of PT they received after their stroke.
Discussion
This study describes the level of ambulation for a cohort of home-dwelling people with stroke on discharge from PT services. Our findings suggest that although mobility outcomes were good overall, almost one third of the people were still unable to walk unsupervised in their communities. Of those who did achieve independent community ambulation, most were reluctant, or unable, to use public transportation and therefore had to rely on their carers if they were to go outside the home. Although
Conclusions
Despite favorable mobility outcomes having been achieved for this home-dwelling cohort of people with stroke, questions remain as to why such outcomes are not necessarily linked to good levels of community ambulation. It may be that rehabilitation efforts need to be refined to achieve a level of mobility sufficient for these people to be adept community ambulators. Research is required to identify treatment approaches that maximize community ambulation based on the attributes required for the
Acknowledgements
We thank the research assistants who collected data at each of the centers: Jackie Pithie at Princess Margaret Hospital, Leanne Robinson at Waikato Hospital, and Nik Yarrall at Hutt Hospital, and the physical therapists at the 3 centers.
References (27)
- et al.
Balance and mobility outcomes for stroke patientsa comprehensive audit
Aust J Phys Ther
(1997) - et al.
Mobility status after inpatient stroke rehabilitation1-year follow-up and prognostic factors
Arch Phys Med Rehabil
(2001) - et al.
Responsiveness and predictability of gait speed and other disability measures in stroke
Arch Phys Med Rehabil
(2001) - et al.
Muscle strengthening and physical conditioning to reduce impairment and disability in chronic stroke survivors
Arch Phys Med Rehabil
(1999) - et al.
Functional community ambulationwhat are your criteria?
Clin Manag Phys Ther
(1986) - et al.
Classification of walking handicap in the stroke population
Stroke
(1995) - et al.
A patient-centred study of the consequences of stroke
Clin Rehabil
(1998) - et al.
Functional ambulation velocity and distance requirements in rural and urban communities
Phys Ther
(1988) - et al.
Dimensions of mobilitydefining the complexity and difficulty associated with community mobility
J Aging Phys
(1999) - et al.
Environmental demands associated with community mobility in older adults with and without mobility disorders
Phys Ther
(2002)
Changes in the quality of life of hemiplegic stroke patients with time
Am J Phys Med Rehabil
A long-term follow-up of stroke patients
Stroke
Psychosocial function and life satisfaction after stroke
Stroke
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Supported by the New Zealand Society of Physiotherapists.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.