Purpose: Stroke is a leading cause of limited mobility status among adults. Although survivors of stroke may recover some ability to complete functional mobility, successful community mobility remains limited. The aim of this study was to explore the alignment of perceptions regarding community mobility between adults post-stroke and their physical therapists after discharge from physical therapy.
Participants: Six pairs of adults post-stroke and their physical therapists.
Method: A mixed methods approach utilizing individual semi-structured interviews followed by open coding with concurrent triangulation to the Environmental Analysis of Mobility Questionnaire 2.0 was employed to formulate overarching themes of perspectives pertaining to community mobility encounters and avoidances.
Results: Qualitative analysis revealed three themes that facilitated community mobility: 1) collaborative goals, 2) support systems, and 3) meaningful interventions. Five themes were found to detract from community mobility: 1) societal perceptions, 2) safety, 3) levels of function, 4) upper extremity function, and 5) third party influences. EAMQ 2.0 data supported interventions that addressed encounters within the temporal, terrain, and distance dimensions. The adults post-stroke reported higher avoidance scores on the physical load dimension of the EAMQ, while this dimension was unaddressed by physical therapists.
Conclusions: Commonalities between groups built upon collaboration toward an optimal outcome for enhanced community mobility after stroke. A clear understanding of a patient’s perspective may allow for the physical therapist to better select interventions to address their environmental mobility needs.
Clinical Relevance: Utilization of a battery of outcome measures, inclusive of the EAMQ 2.0 may provide physical therapists with a robust picture necessary to develop a plan of care encompassing community mobility. Addressing all dimensions of community mobility in addition to incorporation of the perceptions of an adult post-stroke may enhance the tailoring of post-stroke rehabilitation episodes of care and lead to enhanced outcomes.