Nanninga Christa S, Meijering Louise, Postema Klaas, Schönherr Marleen C, Lettinga Ant T
a Center for Rehabilitation , University Medical Center Groningen, University of Groningen , Haren , The Netherlands.
b Population Research Centre, Urban and Regional Studies Institute, Faculty of Spatial Sciences , University of Groningen , Groningen , The Netherlands.
Disabil Rehabil. 2018 Aug;40(17):2015-2024. doi: 10.1080/09638288.2017.1323031. Epub 2017 May 17.
To enrich the discussion on mobility in stroke rehabilitation by translating theoretical repertoires of mobility from the context of geography to rehabilitation.
Qualitative research methodology was applied, and included in-depth interviews with stroke survivors.
This study revealed: (a) social and material differences in clinical, private and public places; (b) ambivalences and shifting tensions in bodily, family and community life; (c) differences in access to resources to be used for mobility. Moving around safely was not a matter of being physically able to walk independently, it also involved dealing with different human actors - such as children, partners and shoppers, and non-human actors - such as doorbells and traffic rules. Stroke survivors had to balance exercise and training, family and working life, and leisure and pleasure, and to renegotiate their mobility in each context.
Our study showed that mobility has many aspects that interact with each other in multiple ways for stroke survivors when they return home and thereafter. The current focus on adherence to mobility and exercise training at home needs to be critically reviewed as it does not capture the multiplicities embodied in real-life settings. Implications for rehabilitation Rehabilitation medicine needs to consider mobility as a way to connect places that are meaningful to individuals rather than as movements from A to B. Clinical outcome measurement tools, such as the 10-meter walk test, are inadequate for evaluating participation in the mobility domain at home or in the community. Mobility issues at the participation domain need to be considered in "how they hang together" rather than distinguished in different disciplinary domains. Rehabilitation practitioners should teach stroke survivors concrete strategies on how to creatively deal with the ambivalences and tensions around mobility in home and community life.
通过将移动性的理论体系从地理学背景转换到康复领域，丰富关于中风康复中移动性的讨论。
采用定性研究方法，包括对中风幸存者进行深入访谈。
本研究揭示了：（a）临床场所、私人场所和公共场所中的社会及物质差异；（b）身体、家庭和社区生活中的矛盾心理及变化的紧张关系；（c）获取用于移动的资源方面的差异。安全移动不仅仅是身体能够独立行走的问题，还涉及与不同的人类行为者（如儿童、伴侣和购物者）以及非人类行为者（如门铃和交通规则）打交道。中风幸存者必须在锻炼与训练、家庭与工作生活、休闲与娱乐之间取得平衡，并在每种情境中重新协商他们的移动性。
我们的研究表明，对于中风幸存者回家后及之后的情况，移动性有许多相互作用的方面。目前对在家坚持移动性和运动训练的关注需要进行批判性审视，因为它没有涵盖现实生活场景中所体现的多样性。对康复的启示 康复医学需要将移动性视为连接对个人有意义的场所的一种方式，而不是从A点到B点的移动。诸如10米步行测试等临床结果测量工具不足以评估在家或社区中在移动性领域的参与情况。在参与领域的移动性问题需要从“它们如何相互关联”的角度来考虑，而不是在不同学科领域中加以区分。康复从业者应该教导中风幸存者具体的策略，以创造性地应对家庭和社区生活中围绕移动性的矛盾心理和紧张关系。
