Outdoor Environmental Facilitators and Barriers of Stroke Survivors’ Mobility and Functional Status

户外环境对中风幸存者的促进因素和障碍——行动能力和功能状态

基本信息

批准号：
9922118
负责人：
Erica Twardzik
金额：
$ 3.67万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-05-01 至 2021-04-15
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9922118
关键词：
Activities of Daily Living Address Adult Affect Age American Ancillary Study Area Caregivers Caring Communities Data Data Analyses Data Collection Data Sources Development Development Plans Elderly Environment Future Gait speed Health Home environment Impaired cognition Impairment Individual Interview Loneliness Measurement Medical Mental Depression Methods Nursing Homes Participant Pathway interactions Policies Population Qualitative Methods Reasons for Geographic And Racial Differences in Stroke Reporting Research Research Design Research Project Grants Residual state Resources Sampling Sampling Studies Severities Shapes Site Stroke Surface Survivors Time United States Urban Developments Visual impairment Walking Width acute stroke aging population built environment cohort community involvement disability environmental change follow-up functional disability functional independence functional status health care availability improved post stroke premature social engagement stroke risk stroke survivor time use wearable sensor technology

项目摘要

PROJECT SUMMARY Stroke is a leading cause of serious long-term disability within the United States, and it affects an estimated 6.6 million Americans over age 20. Medical advances in treatment of acute stroke and an aging population have resulted in a greater number of stroke survivors in our population, and many stroke survivors return directly home. With a greater number of stroke survivors living in their local community, it is critical to determine which features of the local environment best support stroke survivors' functional status, especially features that support mobility. Mobility impacts health through various mechanisms, including social engagement, community involvement, and access to health care resources. Using a mixed methods study design, the proposed project will determine which features of the outdoor environment are most important for mobility and functional status in the first 18 months post-stroke. This research project will consist of a secondary data analysis of existing data by combining three, rich data sources and primary data collection using mobile inertial measurement units and qualitative methods. Specifically, this research project will address the following aims: 1) Examine the moderating effect of environmental features found on participants' residential blocks on the relationship between stroke severity and 18-month trajectory of functional status post stroke, 2) Identify environmental features that moderate the relationship between stroke severity and mobility adaption (i.e. slower gait speed) in real-time using wearable sensors (i.e. mobile inertial measurement units), and 3) Identify the most salient environmental features for functional status and mobility as reported by stroke survivors using qualitative interviews. The mixed methods approach allows the examination of which environmental features interact with stroke impairment to result in differential functional status (Aim 1), how stroke impairment interacts with environmental features to affect mobility (Aim 2), and why environmental features affect mobility and functional status from the perspective of stroke survivors themselves (Aim 3). This research will identify potential ways to increase stroke survivors' mobility and independence by determining how to maximize the accessibility of the outdoor built environment. The findings of this research will inform planning and policy regarding which components of the built environment are most important for survivors' mobility and functional independence. Ultimately, positive environmental changes can improve stroke survivors' functional independence and decrease stroke survivors' reliance on caregivers, premature relocation to nursing home facilities, and development of secondary conditions (e.g. depression, cognitive decline).

项目摘要中风是美国严重长期残疾的主要原因，它影响估计6.6 20岁以上的百万美国人。急性中风和人口老龄化的医疗治疗进展导致我们人口中有更多的中风幸存者，许多中风幸存者直接返回家。有更多的中风幸存者居住在当地社区，至关重要的是确定哪个当地环境的特征最佳支持中风幸存者的功能状态，尤其是特征支持移动性。流动性通过包括社会参与在内的各种机制影响健康，社区参与，并获得医疗保健资源。使用混合方法研究设计，拟议的项目将确定室外环境的哪些功能对于移动性和冲程后18个月的功能状态。该研究项目将由二级数据组成通过使用移动惯性组合三个丰富的数据源和主要数据收集来分析现有数据测量单元和定性方法。具体而言，该研究项目将解决以下目的： 1）检查参与者的住宅块对环境特征的调节作用中风后的中风严重程度与18个月的功能状态轨迹之间的关系，2）确定环境特征，以减轻行程严重程度和移动性适应之间的关系（即使用可穿戴传感器（即移动惯性测量单元）实时实时步态速度），3）确定使用中风幸存者报告的功能状态和机动性的最显着环境特征定性访谈。混合方法方法允许检查哪些环境特征与中风障碍相互作用，从而导致功能差异（AIM 1），中风障碍如何与环境特征相互作用以影响流动性（AIM 2），以及为什么环境特征影响流动性从中风幸存者本身的角度来看（目标3）。这项研究将确定通过确定如何最大化，增加中风幸存者的流动性和独立性的潜在方法室外建筑环境的可访问性。这项研究的发现将为计划和政策提供信息关于建筑环境的哪些组成部分对于幸存者的流动性和功能最重要独立。最终，积极的环境变化可以改善中风幸存者的功能独立和减少中风幸存者对看护人的依赖，过早搬迁到疗养院设施和次要条件的发展（例如抑郁症，认知能力下降）。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

"Well in in this neighborhood I have walked, not at all": Stroke survivors lived experience in the outdoor environment.

DOI：
10.1016/j.socscimed.2022.115107
发表时间：
2022-07
期刊：
SOCIAL SCIENCE & MEDICINE
影响因子：
5.4
作者：
Twardzik, Erica;Colabianchi, Natalie;Duncan, Lilia;Lisabeth, Lynda D.;Brown, Susan H.;Clarke, Philippa J.
通讯作者：
Clarke, Philippa J.

Disability During a Pandemic: Student Reflections on Risk, Inequity, and Opportunity.

大流行期间的残疾：学生对风险、不平等和机会的反思。