An Investigation Of The Factors Associated With Community Ambulation In Chronic Stroke
Loss of independent community ambulation is one of the most disabling consequences of stroke. While the relationship between gait speed and community ambulation has been well established, other underlying factors that may influence return to independent community ambulation post stroke are not clearly understood.
Aims and Objectives:
The aim of this research was to investigate the factors associated with community ambulation in patients between one and three years post stroke. More specifically, it examined the association of multiple personal and post stroke factors with community ambulation and which factors were independently associated with community ambulation.
A cross-sectional study design was used. Forty community-dwelling stroke patients, between one and three years post stroke were recruited into the study. Each participant attended Baggot Street Hospital for one assessment. The primary outcome measure was a Community Ambulation Questionnaire. Other outcome measures included: 10 Metre Walk Test, Timed-Up and Go Test, Activities-Specific Balance Confidence Scale, Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Trail-Making Test-Part B and Single Letter Cancellation Test. Demographic information was also recorded ii
Age, number of medications and use of a walking aid were found to be significantly associated with community ambulation (p ≤ 0.05). Gait speed, walking balance and balance self-efficacy were also found to be significantly associated with community ambulation (p ≤ 0.05). Balance self-efficacy was the only factor independently associated with community ambulation post stroke.
Balance self-efficacy may be a significant determinant in the attainment of independent community ambulation post stroke. This suggests that physical aspects such as gait speed and walking balance should not be considered in isolation when addressing community ambulation post stroke.
Implication of Findings:
Clinically, the results support the need for assessment and treatment of balance self-efficacy when addressing community ambulation post stroke. Also, the role of balance self-efficacy should be considered when developing future outcome measures and interventions for community ambulation post stroke.