The Influence of Walking Limitations on Daily Life: A Mixed-Methods Study of 14 Persons with Late Effects of Polio
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Design
2.2. Participants
2.3. Ethics
2.4. Data Collection
2.5. Data Analysis
3. Results
3.1. The Ratings of the Items in Walk-12 and the Corresponding Qualitative Data
3.2. The Deductive Analysis
3.2.1. Limited Ability to Walk (Item 1)
I can only walk three steps, then my back starts hurting…[P8]
In many situations, you really are [limited in your walking ability].Especially when it comes to moving around. Like walking in stores, for instance… I don’t like when it´s too crowded, either. When we have been to an ice hockey arena and there are too many people there, there’s immediately a feeling of imbalance, having to parry people and THAT is tough.[P7]
3.2.2. Limited Ability to Run (Item 2)
…I tried to run when I was younger, but I can´t do that anymore…[P7]
When the grandchildren come to visit I play with them, play hide and seek and play with them outside and stuff. But if there’s a lot of running and ball-kicking grandpa is the one who has to do that.[P9]
3.2.3. Limited Ability to Climb Up or Down Stairs (Item 3)
Before I didn’t have to think before climbing down the stairs, but today I like to hold on to banisters if there are any. Before I was able to get down without having to hold on, but I don’t dare to do that anymore. Something has happened to the bad leg, sometimes it’s as if it doesn’t want to cooperate with [me].[P10]
…I used to drive to swim in the sea. Icannot do that longer because you have to go down a stair and I do not know if I am able to climb up again.[P8]
3.2.4. Difficulty to Stand When Doing Things (Item 4)
I always sit on it [the shower board] when I shower.Or I stand up at first and then sit down. I’m afraid of standing up in the bathtub even if I’m standing on a rubber mat.[P3]
…I have a stool in the kitchen, a bar stool that we bought when I fell many years ago and couldn’t stand because my foot was sprained again…. I pull it out when I need to, for example when standing and peeling a lot or when standing and working, I can sit sometimes, and that’s great.[P9]
…I sing in the choir as well, and we stand quite a lot when there is a concert, and it affects [me]. Because then… it feels both in the legs and back….[P11]
3.2.5. Limited Balance When Standing or Walking (Item 5)
Nowadays it’s a lot harder to move… IfI’m getting something and have to get up. Now I have support and crutches and make sure I stand properly before I take a step.[P5]
Darkness is not good. Inow notice that it is not… I get shaky when I walk when it´s dark. So it’s not that fun to be outdoors in the dark yourself, it’s not. Somehow you´re more imbalanced when it’s dark… You can´t see anything…[P7]
3.2.6. Limited Walking Distance (Item 6)
You walk to the best of your ability… It’s not very far.I walk outside the house, go for a short walk. It’s not very far. I have trouble with walking long distances.[P10]
… I can´t walk as much nowadays as I would like to… I feel that I´m getting increasingly tired and I get a lot of pain if I, for example, walk as far as I did half a year ago. That really bothers me that I can´t do that anymore…[P7]
3.2.7. Increased Effort When Walking (Item 7)
…walking on slopes, it’s hard… andthe same with stairs… Then you must constantly think about how to place the foot…[P11]
3.2.8. Necessary to Use Support When Walking Indoors (Item 8)
I can’t go to the bathroom without a walker. The risk of falling is too high.[P8]
At home I always walk so I can get support from walls, tables and other similar things. I think I do it unconsciously, if I were to get unstable I can always grab something.[P5]
3.2.9. Necessary to Use Support When Walking Outdoors (Item 9)
Then I’ve also gotten those dictus bands that help me greatly when I’m outside… I have them on when I know I’ll be walking long distances. I’ve also gotten some kind of orthosis that’s supposed to help stabilize my left leg which is also really good.[P5]
I put studs on my crutch, anti-slips. Then you get to have a pair of sturdy winter shoes. You cannot go out with shoes with plastic soles. You have to make sure that you have the right shoes when it´s slippery. You are also extra careful…[P2]
It´s difficult to walk with Nordic walkers in forest and land with hilly ground. I have always enjoyed going out into the forest and picking mushrooms but I experience that it has become much more difficult today than before… Then I need support and use my cane. It doesn’t work as well with Nordic walkers in the forest.[P5]
3.2.10. Slowed Down Walking Speed (Item 10)
You learn that you can’t walk too fast, you need to take it easy. You always have to make sure you’re on time and that’s not always easy. But the faster I walk, the worse it gets. The easier it is to fall, or to feel like you get a bit unstable.[P7]
3.2.11. Ability to Walk Smoothly (Item 11)
Something has happened to the weakest leg, sometimes it’s just as if it doesn´t want to follow. The foot, or yes, the lower leg… Has no control over it. I didn´t have that problem before, but I do now…[P10]
When I’m outside walking it’s just as if my right leg [jams itself] in a strange way right at the moment when I put it down and my left leg leaves the ground. I need the ground to be completely flat. Just something small in the way is enough.[P2]
3.2.12. Concentration When Walking (Item 12)
It takes a lot of energy to concentrate on how to walk and it´s of course affected if there are a lot of people in the store.[P5]
I look down more, look where I put my feet. I never had to do that before. I do it for safety.[P4]
4. Discussion
4.1. Methodological Considerations and Clinical Implications
4.2. Strength and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Age | |
---|---|
Mean years (SD), range | 70 (5), 61–78 |
Age at acute polio | |
Mean years (SD), range | 4 (4), 1–12 |
Duration of new LEoP-related impairments | |
Mean years (SD), range | 26 (9), 9–43 |
Self-perceived degree of LEoP | |
Mild/moderate/severe (n) | 3/6/5 |
Use of mobility aids | |
Indoors or outdoors (n) | 11 |
Living situation | |
Living with a partner/alone (n) | 11/3 |
Resident | |
Living in a house/apartment (n) | 8/6 |
Ground around the residence | |
Even/uneven (n) | 12/2 |
Fall frequency the past year | |
0 time/1–3 times/4–6 times | 2/7/5 |
In the Past 2 Weeks How Much Has Your Post-Polio… | Not at All n (%) | A Little n (%) | Moderately n (%) | Quite a Bit n (%) | Extremely n (%) |
---|---|---|---|---|---|
1. Limited your ability to walk? | 3 (21) | 1 (7) | 4 (29) | 4 (29) | 2 (14) |
2. Limited your ability to run? | 0 | 2 (14) | 1 (7) | 2 (14) | 9 (64) |
3. Limited your ability to climb up or down stairs | 1 (7) | 4 (29) | 2 (14) | 4 (29) | 3 (21) |
4. Made standing when doing things more difficult? | 3 (21) | 2 (14) | 4 (29) | 4 (29) | 1 (7) |
5. Limited your balance when standing or walking? | 1 (7) | 3 (21) | 5 (36) | 4 (29) | 1 (7) |
6. Limited how far you are able to walk? | 0 | 4 (29) | 0 | 7 (50) | 3 (21) |
7. Increased the effort needed for you to walk? | 0 | 4 (29) | 2 (14) | 6 (43) | 2 (14) |
8. Made it necessary for you to use support when walking indoors, e.g., holding on to furniture, using a stick, etc.? | 5 (36) | 1 (7) | 3 (21) | 4 (29) | 1 (7) |
9. Made it necessary for you to use support when walking outdoors, e.g., using a stick or frame, etc.? | 4 (29) | 1 (7) | 1 (7) | 5 (36) | 3 (21) |
10. Slowed down your walking? | 1 (7) | 3 (21) | 0 | 8 (57) | 2 (14) |
11. Affected how smoothly you walk? | 0 | 4 (29) | 0 | 7 (50) | 3 (21) |
12. Made you concentrate on your walking? | 0 | 4 (29) | 3 (21) | 7 (50) | 0 |
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Brogårdh, C.; Lexell, J.; Hammarlund, C.S. The Influence of Walking Limitations on Daily Life: A Mixed-Methods Study of 14 Persons with Late Effects of Polio. Int. J. Environ. Res. Public Health 2022, 19, 8157. https://doi.org/10.3390/ijerph19138157
Brogårdh C, Lexell J, Hammarlund CS. The Influence of Walking Limitations on Daily Life: A Mixed-Methods Study of 14 Persons with Late Effects of Polio. International Journal of Environmental Research and Public Health. 2022; 19(13):8157. https://doi.org/10.3390/ijerph19138157
Chicago/Turabian StyleBrogårdh, Christina, Jan Lexell, and Catharina Sjödahl Hammarlund. 2022. "The Influence of Walking Limitations on Daily Life: A Mixed-Methods Study of 14 Persons with Late Effects of Polio" International Journal of Environmental Research and Public Health 19, no. 13: 8157. https://doi.org/10.3390/ijerph19138157