Foot and Ankle Impairments Affecting Mobility in Stroke
Rogers, A. 2022. Foot and Ankle Impairments Affecting Mobility in Stroke. PhD Thesis University of East London School of Health, Sport and Bioseince https://doi.org/10.15123/uel.8q711
Altered foot characteristics are common in people with stroke, with a third presenting with abnormal foot posture which is associated with ambulatory difficulties. Understanding the relationship between measures of foot and ankle impairment and their association with mobility and balance outcomes is therefore important; however, poor clinimetric properties of foot and ankle measures after stroke precludes evaluation of these relationships. Therefore, this research, undertaken as part of a multicentred research project, had the following aims:
In Study 1, community-dwelling people with stroke, able to walk 10 m (metres), attended two testing sessions to evaluate the clinimetric properties of different foot and ankle measures. These included: static foot posture and dynamic foot loading (peak plantar pressure, PPP, contact area, CA and centre of pressure, CP) using a plantar pressure mat; isometric muscle strength using a hand-held dynamometer (HHD); peak ankle and hallux dorsiflexion and stiffness using bespoke rigs; and ankle plantarflexion spasticity using the Tardieu scale. Statistical analysis used intraclass correlation coefficients (ICCs₍₃,₁₎), standard error of measurement (SEM) and Bland–Altman plots.
In Study 1, 21 people with stroke tested the measures. These were found to be feasible and easy to administer, although loss of data (up to 33%) was observed. All measures had moderate to excellent test–retest reliability (coefficients 0.50‒0.98), except ankle plantarflexion stiffness (ICCs₍₃,₁₎ = 0.00‒0.11).
The study demonstrated that seven foot and ankle measures of impairment after stroke were clinically feasible, reliable and associated with mobility and balance outcomes. The measures were ankle and foot isometric muscle strength, sway velocity, PPP (RFT and FFT), CA (MFT and FFT) and peak ankle dorsiflexion. These measures can now be incorporated into research to examine methods to improve the treatment of foot and ankle after stroke.
|Publisher||University of East London|
|Digital Object Identifier (DOI)||https://doi.org/10.15123/uel.8q711|
File Access Level
|Online||01 Apr 2022|
|Publication process dates|
|Deposited||01 Apr 2022|
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