The Perspectives of Individuals with Chronic Stroke on Motor Recovery: A Qualitative Analysis

Author:

Cain Amelia1ORCID,Winstein Carolee J.12ORCID,Demers Marika34ORCID

Affiliation:

1. Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90033, USA

2. Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA

3. École de Réadaptation, Université de Montréal, Montreal, QC H3N 1X7, Canada

4. Institut Universitaire de Réadaptation en Déficience Physique de Montréal, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, CIUSSS Centre-Sud-de-l’Ile de Montréal, Montreal, QC H3S 1M9, Canada

Abstract

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care.

Funder

Southern California Clinical and Translational Science Institute

Small Business Technology Transfer funds

Justin Rowe

Fonds de la Recherche en Santé du Québec

Sainburg and Winstein, MPI

National Center for Advancing Translational Science

Publisher

MDPI AG

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