PhD, University of Cincinnati, 2021, Medicine: Epidemiology (Environmental Health)
Purpose/Hypothesis: To examine the influence of the home environment of stroke survivors on standardized gait tests, with a focus on turns, surface changes, and doorways in the walkway. We hypothesized that the walking environment (home versus laboratory) would influence stroke survivor gait speed and distance, and that environmental factors in the home would contribute to this difference. Predictive models were created for use by therapists in the home to compare results to lab based standards.
Subjects: Individuals (n=18) = six months post stroke with minority or lower socioeconomic status who were subjects in a larger NIMHD-funded pilot study investigating a lifestyle intervention were included in this study. Thirteen (72%) were Black, and five (28%) were White. Ten (56%) lived in an apartment and 8 (44%) lived in a house. Mean comfortable gait speed (CGS) during Lab 10 meter walk test (10mWT) was 0.61m/s.
Methods: Home walkways for testing were selected with two criteria: minimize turns, with no “U” turns in the walkway, and leave furnishings in place for ecological validity. Paired tests compared gait measures between the laboratory and the subject's home including the 10mWT, 5 meter walk test (5mWT), 2 minute walk test (2MWT), and 6 minute walk test (6MWT). Fast gait speed (FGS) and CGS were measured. Analyses of turns, surface changes, doorways, and fast/slow walking speed were performed for each of the above walking tests. Predictive models for Lab 10mWT and Lab 6MWT were created using home-derived gait measures using multivariate regression.
Results: Several gait speed measures were significantly different (p<0.05) between lab and home, indicating slower walking at home. Mean difference (lab versus home) and p-values were as follows: 10mWT CGS 0.05 m/s (p=0.04), 10mWT FGS 0.04 m/s (p=0.04), 5mWT CGS 0.04 m/s (p=0.12), 5mWT FGS 0.10 m/s (p=0.02), 2MWT 3.73 m (p=0.16), 6MWT 8.67 m (p=0.10). Comparing Lab vs Home for the 10mWT FGS, there was a signif (open full item for complete abstract)
Committee: Kari Dunning Ph.D. (Committee Chair); Pierce Boyne D.P.T. (Committee Member); Valerie Hill Ph.D. (Committee Member); Marepalli Rao Ph.D. (Committee Member)
Subjects: Epidemiology