What does real-world walking mean to people with stroke? An interpretive descriptive study

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 REHABILITATION

• Real-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
• stroke
• confidence
• rehabilitation

Acknowledgements

This project was completed while Caroline Stretton was the recipient of a Laura Fergusson Doctoral Scholarship and Doctoral Fees Scholarship from the Faculty of Health Sciences, AUT University. Suzie Mudge was supported by a Waitemata District Health Board Post-Doctoral Research Fellowship. Kath McPherson’s position during the study as Professor of Rehabilitation was part supported by the Laura Fergusson Trust Auckland.

Disclosure statement

No potential conflict of interest was reported by the author(s).