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What Does Real-world Walking Mean to People With Stroke? An Interpretive Descriptive Study

Stretton, CM; Mudge, S; Kayes, NM; McPherson, KM
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http://hdl.handle.net/10292/13491
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Abstract
Purpose: Understanding personal experiences of real-world walking for stroke survivors could assist clinicians to tailor interventions to their clients' specific needs. We explored the research questions: "What does real-world walking mean to people after stroke and how do they think it can be better?"Method: Using an Interpretive Descriptive methodology, we purposively sampled eight stroke survivors who reported difficulty walking in the real-world. We sought diversity on key participant characteristics. Participants were interviewed using a semi-structured guide. Data were analysed with thematic analysis.Results: Many found real-world walking, particularly in the outdoors, created opportunities for freedom from dependence and a visible step by step progress, which generated hope for future recovery. Conversely, when participants did not experience sufficient progress, they expressed negative emotions. Participants strove to overcome challenges to their walking goals using everyday routines, planning skills, and confidence building experiences to motivate themselves. They also drew on, and extended, social resources highlighting the relational aspects of real-world walking.Conclusions: Walking in their real-world provided a meaningful, desirable, but challenging goal for participants that required significant emotional effort. Successful progress in real-world walking builds confidence and hope and can contribute to psychological wellbeing by providing opportunities for successful mastery and social connectedness.IMPLICATIONS FOR REHABILITATIONReal-world settings can be unpredictable which makes walking in the real-world after stroke demanding.Positive experiences of walking in the real-world can provide significant psychological benefits to stroke survivors.Many survivors need to carefully concentrate on the act of walking in outdoor settings.Pre-planning routes, confidence-building experiences and developing daily routines may help patients overcome these challenges.
Keywords
Walking; Community ambulation; Confidence; Rehabilitation; Stroke
Date
May 29, 2020
Source
Disability and Rehabilitation, DOI: 10.1080/09638288.2020.1767704
Item Type
Journal Article
Publisher
Taylor & Francis
DOI
10.1080/09638288.2020.1767704
Publisher's Version
https://www.tandfonline.com/doi/full/10.1080/09638288.2020.1767704
Rights Statement
Copyright © 2020 Taylor & Francis. Authors retain the right to place his/her pre-publication version of the work on a personal website or institutional repository as an electronic file for personal or professional use, but not for commercial sale or for any systematic external distribution by a third. This is an electronic version of an article published in (see Citation). Disability and Rehabilitation is available online at: www.tandfonline.com with the open URL of your article (see Publisher’s Version).

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