Is walking faster or walking farther more important to persons with chronic stroke?

Abstract

Purpose: The purposes of this mixed-methods study were to (1) investigate whether walking faster or walking farther was more important for getting “out and about” to persons with chronic stroke and (2) explore explanations for walking preferences. Method: A convenience sample of 77 adults with chronic stroke completed questionnaires and walking outcomes in one visit. Participants were asked whether walking faster or farther was more important to them for getting “out and about”, and differences between response groups (faster vs. farther) were evaluated. Participants also described their preference for walking faster or farther. Qualitative responses were analyzed using content analysis. Results: The majority of participants (76%; n = 58) reported walking farther was more important, while 18% (n = 14) reported walking faster was more important. Statistically significant differences were not found between response groups for any variable. Primary themes identified from participant preferences for walking faster included: (1) faster speed equals better walking ability and (2) getting places faster/quicker. Primary themes from preferences for walking farther included: (1) engaging in activity and participation within home and community; (2) walking farther at a slower pace; and (3) fatigue with walking. Conclusions: Individual preferences for walking faster versus walking farther by persons with chronic stroke should be considered by clinicians when making decisions for rehabilitation.

Implications for Rehabilitation

• Individual preferences for walking faster versus walking farther by patients with chronic stroke should be considered by rehabilitation clinicians when making decisions about examination and intervention.

• The majority of participants with chronic stroke in this study indicated the importance of walking farther in order to better engage in activities both at home and away from home.

• Interventions that focus on improving endurance and energy conservation may need to be used for persons with chronic stroke who want to walk father in order to maximize their potential for walking longer distances.

Keywords::

• Gait endurance
• stroke
• walking

Acknowledgments

We thank the research assistants who completed recruitment, data collection and data entry on this project: Rebecca Phipps, PT, DPT; Lauren Dye, OTR; and Erin DeBaun, OTS.

Declaration of Interest: This project was supported by NIH/NCRR Grant Number RR025761. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Dr. Schmid was supported by a Career Development Award from the Department of Veteran Affairs Rehabilitation Research & Development Service (VA RR&D CDA D6174W).