Article

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 Rehabilitation
Foot 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.

Langue : ANGLAIS