Article

OBJECTIVE: To develop a model of community ambulation after stroke based on:
Canadian data from community-dwelling individuals post-stroke; the experiences
and opportunities for community ambulation expressed by individuals with stroke;
and current literature. The model presents a visual depiction of the
relationships between the different factors of community ambulation after stroke.
DESIGN: A quantitative/qualitative explanatory sequential mixed-methods design
was utilized. Secondary data analysis with structural equation modeling resulted
in a community ambulation model. Two focus groups of individuals with stroke were
conducted to verify and explain the model. SETTING: Community. SUBJECTS:
Quantitative data from 227 participants: 142 (63%) male; 63.4 (12.0) years of age
and 2.6 (2.5) years post stroke. Eleven individuals participated in the focus
groups: 6 (55%) male; 61.4 (6.9) years of age and 5.8 (3.3) years since stroke.
MAIN MEASURES: Model variables: items from the EuroQol, Preference Based Stroke
Index, gait speed, Reintegration to Normal Living Index, the Community Health
Activities Model Program for Seniors, and the Geriatric Depression Scale.
RESULTS: The model had reasonable fit with three latent variables: ambulation,
gait speed, and health perceptions (normed chi(2)=1.8, root mean square error of
approximation = 0.060 (0.043; 0.075)). Depression was also a component of
community ambulation. Participants verified the model and added endurance and the
environment as additional components. Participants used self-awareness and
knowledge of the environment to engage in cognitive strategies related to
community ambulation. CONCLUSIONS: A model of community ambulation after stroke
was developed and verified. Recognizing important components of community
ambulation may assist physiotherapists in determining community ambulation goals,
needs, and opportunities in partnership with clients.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS