Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): The views and experiences of people with stroke

Gorst, Terry; Lyddon, Alison; Marsden, Jon; Paton, Joanne; Morrison, Stewart C.; Cramp, Mary; Freeman, Jenny

Abstract

© 2015 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted. 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 RehabilitationFoot 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.

Citation

Gorst, T., Lyddon, A., Marsden, J., Paton, J., Morrison, S. C., Cramp, M., & Freeman, J. (2016). Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): The views and experiences of people with stroke. Disability and Rehabilitation, 38(6), 589-596. https://doi.org/10.3109/09638288.2015.1052888

• Journal Article Type: Article
• Acceptance Date: May 15, 2015
• Online Publication Date: Jun 9, 2015
• Publication Date: Mar 12, 2016
• Deposit Date: Mar 15, 2018
• Publicly Available Date: Mar 15, 2018
• Journal: Disability and Rehabilitation
• Print ISSN: 0963-8288
• Electronic ISSN: 1464-5165
• Publisher: Taylor & Francis
• Peer Reviewed: Peer Reviewed
• Volume: 38
• Issue: 6
• Pages: 589-596
• DOI: https://doi.org/10.3109/09638288.2015.1052888
• Keywords: balance, fear of falls, foot and ankle, mobility, stroke
• Public URL: https://uwe-repository.worktribe.com/output/919079
• Publisher URL: http://dx.doi.org/10.3109/09638288.2015.1052888
• Additional Information: Additional Information : This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 9th June 2015, available online: http://dx.doi.org/10.3109/09638288.2015.1052888.