Christa S Nanninga1, Louise Meijering2, Klaas Postema3, Marleen C Schönherr4, Ant T Lettinga1. 1. a Center for Rehabilitation , University Medical Center Groningen, University of Groningen , Haren , The Netherlands. 2. b Population Research Centre, Urban and Regional Studies Institute, Faculty of Spatial Sciences , University of Groningen , Groningen , The Netherlands. 3. c Department of Rehabilitation Medicine, Center for Rehabilitation , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands. 4. d Department of Rehabilitation Medicine, Center for Rehabilitation , University Medical Center Groningen, University of Groningen , Haren , The Netherlands.
Abstract
PURPOSE: To enrich the discussion on mobility in stroke rehabilitation by translating theoretical repertoires of mobility from the context of geography to rehabilitation. METHOD: Qualitative research methodology was applied, and included in-depth interviews with stroke survivors. RESULTS: This study revealed: (a) social and material differences in clinical, private and public places; (b) ambivalences and shifting tensions in bodily, family and community life; (c) differences in access to resources to be used for mobility. Moving around safely was not a matter of being physically able to walk independently, it also involved dealing with different human actors - such as children, partners and shoppers, and non-human actors - such as doorbells and traffic rules. Stroke survivors had to balance exercise and training, family and working life, and leisure and pleasure, and to renegotiate their mobility in each context. CONCLUSIONS: Our study showed that mobility has many aspects that interact with each other in multiple ways for stroke survivors when they return home and thereafter. The current focus on adherence to mobility and exercise training at home needs to be critically reviewed as it does not capture the multiplicities embodied in real-life settings. Implications for rehabilitation Rehabilitation medicine needs to consider mobility as a way to connect places that are meaningful to individuals rather than as movements from A to B. Clinical outcome measurement tools, such as the 10-meter walk test, are inadequate for evaluating participation in the mobility domain at home or in the community. Mobility issues at the participation domain need to be considered in "how they hang together" rather than distinguished in different disciplinary domains. Rehabilitation practitioners should teach stroke survivors concrete strategies on how to creatively deal with the ambivalences and tensions around mobility in home and community life.
PURPOSE: To enrich the discussion on mobility in stroke rehabilitation by translating theoretical repertoires of mobility from the context of geography to rehabilitation. METHOD: Qualitative research methodology was applied, and included in-depth interviews with stroke survivors. RESULTS: This study revealed: (a) social and material differences in clinical, private and public places; (b) ambivalences and shifting tensions in bodily, family and community life; (c) differences in access to resources to be used for mobility. Moving around safely was not a matter of being physically able to walk independently, it also involved dealing with different human actors - such as children, partners and shoppers, and non-human actors - such as doorbells and traffic rules. Stroke survivors had to balance exercise and training, family and working life, and leisure and pleasure, and to renegotiate their mobility in each context. CONCLUSIONS: Our study showed that mobility has many aspects that interact with each other in multiple ways for stroke survivors when they return home and thereafter. The current focus on adherence to mobility and exercise training at home needs to be critically reviewed as it does not capture the multiplicities embodied in real-life settings. Implications for rehabilitation Rehabilitation medicine needs to consider mobility as a way to connect places that are meaningful to individuals rather than as movements from A to B. Clinical outcome measurement tools, such as the 10-meter walk test, are inadequate for evaluating participation in the mobility domain at home or in the community. Mobility issues at the participation domain need to be considered in "how they hang together" rather than distinguished in different disciplinary domains. Rehabilitation practitioners should teach stroke survivors concrete strategies on how to creatively deal with the ambivalences and tensions around mobility in home and community life.
Entities:
Keywords:
Mobility; community ambulation; geography; participation; qualitative research; stroke
Authors: Francesco Negrini; Giulio Gasperini; Eleonora Guanziroli; Jacopo Antonino Vitale; Giuseppe Banfi; Franco Molteni Journal: Int J Environ Res Public Health Date: 2020-05-02 Impact factor: 3.390