Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, BB913 Box 356490, Seattle, WA 98195, USA.
Phys Ther. 2013 May;93(5):620-7. doi: 10.2522/ptj.20110217. Epub 2013 Jan 17.
Community walking is limited among survivors of stroke; however, the contributing factors are not clearly understood.
This study examined the association of features in the environment with frequency of community walking following stroke.
An observational study design was used, with frequency of community walking data collected prospectively.
Thirty survivors of stroke (mean age=67 years; mean months since stroke=40), and 30 older adults without stroke (mean age=68 years) participated. Frequency of community walking (number of trips, walking-related activities [WRA], and the ratio of WRA to trips) and satisfaction were measured using self-report. The Environmental Analysis of Mobility Questionnaire (EAMQ) was used to determine frequency of encounter with versus avoidance of environmental features during community walking. Negative binomial and linear regression models were used to analyze the association of environmental features with measures of community walking.
Survivors of stroke reported reduced community walking and fewer encounters with and greater avoidance of features within 8 dimensions of the environment compared with a control group of adults without stroke. Following stroke, avoidance of features in some environmental dimensions was associated with frequency of community walking as measured by number of trips, number of WRA, and the ratio of WRA to trips. Environmental features explained little of the variability in community walking.
Limitations included a small sample size and limited diversity among participants. This study examined only physical features in the environment and did not include other environmental factors, such as social support, which may influence participation.
Avoidance of features within some, but not all, environmental dimensions was associated with self-reported frequency of community walking following stroke, suggesting that some environmental features may limit community walking more than others.
社区步行在中风幸存者中受到限制；然而，其影响因素尚不清楚。
本研究旨在探讨环境特征与中风后社区步行频率的关系。
采用观察性研究设计，前瞻性收集社区步行频率数据。
30 名中风幸存者（平均年龄 67 岁；中风后平均时间 40 个月）和 30 名无中风的老年人（平均年龄 68 岁）参与了研究。使用自我报告的方式测量社区步行频率（出行次数、与步行相关的活动[WRA]以及 WRA 与出行次数的比例）和满意度。使用环境移动性分析问卷（EAMQ）来确定社区步行时与环境特征的接触和回避频率。采用负二项和线性回归模型分析环境特征与社区步行测量指标的关系。
中风幸存者报告的社区步行次数减少，与对照组无中风的成年人相比，他们在环境的 8 个维度中遇到的环境特征更少，回避的环境特征更多。中风后，一些环境维度中对特征的回避与出行次数、WRA 数量和 WRA 与出行次数的比例等社区步行频率指标有关。环境特征仅能解释社区步行的一小部分变异性。
样本量小，参与者的多样性有限。本研究仅考察了环境中的物理特征，未包括其他环境因素，如可能影响参与度的社会支持。
一些环境维度中的特征回避与中风后社区步行频率的自我报告有关，这表明一些环境特征可能比其他特征更限制社区步行。
