慢性脑卒中患者日常踏步行为的社会和物理环境因素。
Social and physical environmental factors in daily stepping activity in those with chronic stroke.
机构信息
Department of Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA.
Department of Biostatistics Core Facility, University of Delaware, Newark, DE, USA.
出版信息
Top Stroke Rehabil. 2021 Apr;28(3):161-169. doi: 10.1080/10749357.2020.1803571. Epub 2020 Aug 10.
BACKGROUND, PURPOSE/OBJECTIVE: Walking behavior in the chronic stroke population is multi-factorial. Previous work focused on the role of physical and biopsychosocial factors in understanding daily stepping post stroke. However, qualitative evidence suggests that social and physical environmental factors also affect daily stepping in those with stroke. The purpose of this study was to understand the role of social and physical environmental factors in daily stepping after stroke.
METHODS
A total of 249 individuals ≥6 months post stroke were included in this cross-sectional analysis (129 females, mean age 62.98 years, SD 11.94). The social environment included living situation, work status, and marital status. The physical environment included the Area Deprivation Index (ADI) and Walk Score. At least 3 days of stepping was collected using an accelerometry-based device. Predictors were entered sequentially into a regression model: demographic characteristics, social environmental factors, and physical environmental factors.
RESULTS
After adjusting for demographic factors, social environmental factors explained 6.2% ( =.017) of the variance in post stroke daily stepping. The addition of physical environmental factors improved the model (ΔR =.029, =.024). The final model explained 9.2% ( =.003) of the variance in daily stepping. Lower area deprivation (ADI β = -0.178, =.015) and working (working vs. retired β = -0.187, = .029 and working vs. unemployed β = -0.227, =.008) were associated with greater daily stepping.
DISCUSSION/CONCLUSION: Social and physical environmental factors predicted daily stepping and should be considered when setting expectations relative to the effects of rehabilitation on daily stepping in individuals poststroke.
背景、目的/目标：慢性中风人群的步行行为是多因素的。以前的工作侧重于身体和生物心理社会因素在理解中风后日常跨步中的作用。然而，定性证据表明，社会和物理环境因素也会影响中风患者的日常跨步。本研究旨在了解中风后日常生活中社会和物理环境因素对日常跨步的作用。
方法
本横断面分析共纳入 249 名≥6 个月中风后的个体（129 名女性，平均年龄 62.98 岁，标准差 11.94）。社会环境包括居住情况、工作状况和婚姻状况。物理环境包括区域贫困指数（ADI）和步行分数。使用基于加速度计的设备至少收集 3 天的步数。预测因子按顺序输入回归模型：人口统计学特征、社会环境因素和物理环境因素。
结果
在调整人口统计学因素后，社会环境因素解释了中风后日常跨步的 6.2%（=.017）的方差。添加物理环境因素可改善模型（ΔR.029，=.024）。最终模型解释了日常跨步的 9.2%（=.003）的方差。较低的区域贫困（ADI β= -0.178，=.015）和工作（与退休相比β= -0.187，=.029，与失业相比β= -0.227，=.008）与更大的日常跨步相关。
讨论/结论：社会和物理环境因素预测了日常跨步，在设定与中风后个体康复对日常跨步影响相关的期望时应予以考虑。
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