Improving physical mobility is critical for wellbeing in people with severe impairment after an acquired brain injury: a qualitative study

ABSTRACT

Objectives

1) Understand the experience, and personal significance, of mobility skills for people with severe mobility impairment after brain injury 2) Determine how these evolve over time.

Design

Longitudinal qualitative study.

Participants

Ten adults, unable to walk at 8 weeks post-injury.

Methods

Participants were interviewed up to three times, at three-month intervals. Semi-structured interviews were transcribed and coded independently by two researchers, then themes developed. Codes were then reviewed longitudinally.

Results

Initial analysis derived six themes: I lost everything overnight; It feels frustrating; Walking is absolutely the most important; I need help; I’m making progress; I can start doing things that I used to be able to do. Participants described overwhelming losses, with loss of mobility affecting many aspects of life. All participants described progress other than walking that was critical for their wellbeing, including assisted standing and transfers without a lifter. Themes from longitudinal analyses: My losses softened by progress; Walking means freedom; Control helps adjustment happen; Challenges keep coming. Over time, participants valued greater control within their lives and progress with mobility was key.

Conclusion

Participants saw mobility as crucial to recovering control of life. Mobility achievements other than independent walking matter to individuals after brain injury.

KEYWORDS:

• Non-ambulant
• dependent
• stroke
• head injury
• longitudinal
• quality of life

Acknowledgments

Thanks to the participants for their support throughout the project, and to the South Australian Brain Injury Rehabilitation Service for support and patience. Many thanks to Dr Michelle Guerin for conducting interviews. Thanks to Dr Gisela van Kessel and Dr Caroline Fryer for advice with the research design.

Disclosure statement

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

Additional information

Funding

This work was supported by the Lifetime Support Authority of South Australia [GA00035]; Royal Adelaide Hospital Research Committee [9705].