Terry Gorst1, Alison Lyddon2, Jon Marsden1, Joanne Paton1, Stewart C Morrison2, Mary Cramp3, Jenny Freeman1. 1. a School of Health Professions, Plymouth University , Plymouth, Devon , UK . 2. b School of Health, Sport & Bioscience, University of East London , London , UK , and. 3. c Department of Allied Health Professions , University of the West of England , Bristol , UK.
Abstract
PURPOSE: To explore the nature and impact of foot and ankle impairments on mobility and balance in community-dwelling, chronic stroke survivors. METHODS: A qualitative research design using face to face semi-structured, audio recorded interviews. Thirteen community-dwelling stroke survivors, all of whom had self-reported foot and ankle impairments, were interviewed (female n = 6, mean age = 67 years, SD = 12 years, mean time since stroke = 4 years, SD = 6 years, right stroke n = 7, left stroke n = 6). A framework analysis approach was used to analyse and interpret transcribed interviews. RESULTS: Three themes emerged: (1) Impact. The influence of foot and ankle impairments on mobility and balance. (2) Standing out. How participants felt they "stood out" because of their impairments and wanted to be normal. (3) Help. The specific help and advice participants received in managing their problems. CONCLUSIONS: Foot and ankle impairments such as pain, altered somatosensory input and weakness significantly contribute to problems with community ambulation, balance and fear of falling in people with chronic stroke. Specific foot and ankle impairments may also negatively contribute to perceptions of physical appearance and self-esteem. Therapeutic management approaches within clinical practice appear to focus mostly on the gross performance of the lower limb with little emphasis on the specific assessment or treatment of the foot or ankle. IMPLICATIONS FOR REHABILITATION: Foot pain, sensory impairments and muscle weakness in the foot and ankle can impact on community ambulation, balance and fear of falling following stroke. Foot and ankle function post-stroke should be routinely assessed and monitored. Clinicians should be aware of the potentially distressing negative perceptions associated with altered gait patterns, footwear and orthotic use.
PURPOSE: To explore the nature and impact of foot and ankle impairments on mobility and balance in community-dwelling, chronic stroke survivors. METHODS: A qualitative research design using face to face semi-structured, audio recorded interviews. Thirteen community-dwelling stroke survivors, all of whom had self-reported foot and ankle impairments, were interviewed (female n = 6, mean age = 67 years, SD = 12 years, mean time since stroke = 4 years, SD = 6 years, right stroke n = 7, left stroke n = 6). A framework analysis approach was used to analyse and interpret transcribed interviews. RESULTS: Three themes emerged: (1) Impact. The influence of foot and ankle impairments on mobility and balance. (2) Standing out. How participants felt they "stood out" because of their impairments and wanted to be normal. (3) Help. The specific help and advice participants received in managing their problems. CONCLUSIONS: Foot and ankle impairments such as pain, altered somatosensory input and weakness significantly contribute to problems with community ambulation, balance and fear of falling in people with chronic stroke. Specific foot and ankle impairments may also negatively contribute to perceptions of physical appearance and self-esteem. Therapeutic management approaches within clinical practice appear to focus mostly on the gross performance of the lower limb with little emphasis on the specific assessment or treatment of the foot or ankle. IMPLICATIONS FOR REHABILITATION: Foot pain, sensory impairments and muscle weakness in the foot and ankle can impact on community ambulation, balance and fear of falling following stroke. Foot and ankle function post-stroke should be routinely assessed and monitored. Clinicians should be aware of the potentially distressing negative perceptions associated with altered gait patterns, footwear and orthotic use.
Entities:
Keywords:
Balance; fear of falls; foot and ankle; mobility; stroke
Authors: Daniel Gomez-Vargas; Felipe Ballen-Moreno; Patricio Barria; Rolando Aguilar; José M Azorín; Marcela Munera; Carlos A Cifuentes Journal: Brain Sci Date: 2021-03-24