Do facilitators and barriers to community ambulation differ among stroke survivors in low resource settings? A cross-sectional study in Nigeria.

IF 2.2 4区医学 Q1 REHABILITATION Topics in Stroke Rehabilitation Pub Date : 2024-10-07 DOI:10.1080/10749357.2024.2411876

Marufat O Odetunde, Olumide A Olaoye, Halimat O Ogwogho, Ayodele Teslim Onigbinde

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Abstract

Purpose: Stroke survivors (SSV) in many low- and middle-income countries experience frustrating participation restriction in community ambulation (CA), which impedes community life. This study assessed facilitators and barriers to CA among community-dwelling SSV in a southwest state of Nigeria.

Methods: This cross-sectional study involved 66 community-dwelling ambulating SSV, purposively recruited from physiotherapy out-patient clinics of selected hospitals in southwest Nigeria. Semi-structured questionnaire containing physical and social environment elements of the ICF domains was administered on respondents. Mobility status at home and community, socio-demographic and clinical data of SSV were also obtained. Responses from open-ended questions were triangulated with appropriate close ended options. Data were analyzed using descriptive statistics and logistic regression at p < 0.05 Alpha value.

Results: Majority of the SSV were independent in their homes (59.1%), used mobility aids (87.9%) and assisted in CA (66.7%). They identified limited physical accessibility by crowds 25 (37.9%), lack of inclined surfaces 40 (95.2%), uneven floors 36 (87.8%), public seating arrangements 33 (78.6%), rain (73.8%) and inability to use services, systems and policies (77.3%) as barriers to CA. Built physical environment was a significant predictor of home (OR = 0.754, p = 0.001) and community mobility (OR = 0.850; p = 0.018), while post-stroke depression was a significant predictor of community mobility (OR = 1.038; p = 0.014).

Conclusion: Mobility aids, social attitudes and general support were identified as facilitators, whereas barriers to CA included built physical environment, services and policies, products and technology. Facilitators and barriers to CA are similar to some HIC contexts, perceived difficulties and experiences differ for infrastructural and social reasons among others.

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在资源匮乏的环境中，中风幸存者在社区行走的促进因素和障碍是否有所不同？尼日利亚的一项横断面研究。

目的：在许多低收入和中等收入国家，脑卒中幸存者（SSV）在社区行走（CA）方面受到限制，影响了社区生活。本研究评估了尼日利亚西南部一个州居住在社区的脑卒中幸存者参与社区步行的促进因素和障碍：这项横断面研究从尼日利亚西南部选定医院的理疗门诊有目的性地招募了 66 名居住在社区的行动不便的 SSV。对受访者进行了半结构化问卷调查，其中包括 ICF 领域的物理和社会环境要素。此外，还获得了 SSV 在家庭和社区的活动状况、社会人口学和临床数据。开放式问题的答案与适当的封闭式选项进行了三角分析。采用描述性统计和逻辑回归对数据进行分析：大多数 SSV 在家中独立生活（59.1%），使用助行器（87.9%），在 CA 中得到协助（66.7%）。他们认为，人多（25 人，占 37.9%）、缺乏斜面（40 人，占 95.2%）、地面不平（36 人，占 87.8%）、公共座位安排（33 人，占 78.6%）、下雨（73.8%）以及无法使用服务、系统和政策（77.3%）等因素都是妨碍他们进行长者活动的障碍。建筑物理环境对居家（OR = 0.754，p = 0.001）和社区行动能力（OR = 0.850；p = 0.018）有显著的预测作用，而卒中后抑郁对社区行动能力（OR = 1.038；p = 0.014）有显著的预测作用：结论：助行器具、社会态度和一般支持被认为是促进社区行动的因素，而阻碍社区行动的因素则包括人造物理环境、服务和政策、产品和技术。在一些高收入国家，便利和障碍性因素是相似的，但由于基础设施和社会等原因，人们感知到的困难和经历有所不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Topics in Stroke Rehabilitation 医学-康复医学

CiteScore

5.10

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.