Nayak N1, Kuys S1, Bilney B2
1Australian Catholic University, School of Physiotherapy, Banyo, QLD, Australia, 2Australian Catholic University, School of Physiotherapy, Ballarat, VIC, Australia
Background: Community walking is a complex task requiring integration of walking with environmental situations such as uneven surfaces and personal factors such as balance confidence. Walking in the community is an important goal for stroke survivors and thus, is important to measure to monitor progress. Currently, community walking measures include assessment of gait speed, distance walked and balance performance. Devices such as accelerometers and global positioning systems can also be used. However, it is important to understand if these commonly used measures are capturing the complexity of community walking. The International Classification of Functioning, Disability and Health (ICF) provides a framework to characterise community walking and offers a structure to explore content of measures in a standardised manner. Exploring the factors covered in these measures would be useful to identify measure/s that captures important factors contributing to community walking and may facilitate selection of relevant measure in clinical practice. A systematic review is needed to identify measures of community walking in stroke survivors and evaluate the content of these measures using the ICF.
Purpose: The purpose of this study is to systematically identify measures of community walking in stroke survivors and to explore the content of identified measures using the ICF framework.
Methods: A systematic literature review was conducted to identify measures of community walking in stroke survivors. Studies were included if participants were adult stroke survivors and community walking was reported as a primary or secondary outcome. All study designs were included. Search strategy was applied in the databases of CINAHL, EMBASE, Web of Science, PubMed, and Scopus. Measurement tools were extracted, and concepts contained in these measures were linked to ICF categories using the ICF linking process.
Results: Twenty-seven studies met the eligibility criteria. Twenty measurement tools were extracted and included in the ICF linking process. Across all measures, 166 categories were linked. The most commonly linked component was activities and participation (88%), which included the categories 'd4502 Walking on different surfaces', 'd4551 Climbing' and 'd4503 Walking around obstacles'. Categories that linked to Environmental factors (10%) included 'e1201' and 'e1208' relating to assistive products and technology for mobility, 'e 2100 Land forms' and 'e2250 Temperature'. Body function categories (2%) covered 'b 1266 Confidence', 'b798 Neuromusculoskeletal and movement function' and 'b260 Proprioception'.
Conclusion(s): Measures of community walking for stroke survivors illustrated diversity in the content covered, with most of the measures covering only one component of ICF, activities and participation. Within activity and participation, most of the measures covered walking related categories, with very few measures covering the participation aspect of walking such as socializing and community life. Environmental factors covered included physical dimension of environment, with little inclusion of social and attitudinal components. These research findings suggest there is a lack of a comprehensive measure for community walking.
Implications: Physiotherapists may need to use multiple measures to capture complexity of community walking, as the current measures seem to focus only on specific contributing factors. There is an opportunity to develop a tool that could capture the important factors of community walking in stroke survivors.
Keywords: Community walking, Measurement, Stroke survivors
Funding acknowledgements: Not applicable.
Purpose: The purpose of this study is to systematically identify measures of community walking in stroke survivors and to explore the content of identified measures using the ICF framework.
Methods: A systematic literature review was conducted to identify measures of community walking in stroke survivors. Studies were included if participants were adult stroke survivors and community walking was reported as a primary or secondary outcome. All study designs were included. Search strategy was applied in the databases of CINAHL, EMBASE, Web of Science, PubMed, and Scopus. Measurement tools were extracted, and concepts contained in these measures were linked to ICF categories using the ICF linking process.
Results: Twenty-seven studies met the eligibility criteria. Twenty measurement tools were extracted and included in the ICF linking process. Across all measures, 166 categories were linked. The most commonly linked component was activities and participation (88%), which included the categories 'd4502 Walking on different surfaces', 'd4551 Climbing' and 'd4503 Walking around obstacles'. Categories that linked to Environmental factors (10%) included 'e1201' and 'e1208' relating to assistive products and technology for mobility, 'e 2100 Land forms' and 'e2250 Temperature'. Body function categories (2%) covered 'b 1266 Confidence', 'b798 Neuromusculoskeletal and movement function' and 'b260 Proprioception'.
Conclusion(s): Measures of community walking for stroke survivors illustrated diversity in the content covered, with most of the measures covering only one component of ICF, activities and participation. Within activity and participation, most of the measures covered walking related categories, with very few measures covering the participation aspect of walking such as socializing and community life. Environmental factors covered included physical dimension of environment, with little inclusion of social and attitudinal components. These research findings suggest there is a lack of a comprehensive measure for community walking.
Implications: Physiotherapists may need to use multiple measures to capture complexity of community walking, as the current measures seem to focus only on specific contributing factors. There is an opportunity to develop a tool that could capture the important factors of community walking in stroke survivors.
Keywords: Community walking, Measurement, Stroke survivors
Funding acknowledgements: Not applicable.
Topic: Neurology: stroke
Ethics approval required: No
Institution: Australian Catholic University (ACU), Brisbane, Australia
Ethics committee: ACU Human Research Ethics Committee
Reason not required: Systematic review of literature
All authors, affiliations and abstracts have been published as submitted.
