title: Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): the views and experiences of people with stroke.
abstract: OBJECTIVE
  To explore the nature and impact of foot and ankle impairments on mobility and balance in community-dwelling, chronic stroke survivors.
  
  
  METHODS
  A qualitative research design using face to face semi-structured, audio recorded interviews. Thirteen community-dwelling stroke survivors, all of whom had self-reported foot and ankle impairments, were interviewed (female n = 6, mean age = 67 years, SD = 12 years, mean time since stroke = 4 years, SD = 6 years, right stroke n = 7, left stroke n = 6). A framework analysis approach was used to analyse and interpret transcribed interviews.
  
  
  RESULTS
  Three themes emerged: (1) Impact. The influence of foot and ankle impairments on mobility and balance. (2) Standing out. How participants felt they "stood out" because of their impairments and wanted to be normal. (3) Help. The specific help and advice participants received in managing their problems.
  
  
  CONCLUSIONS
  Foot and ankle impairments such as pain, altered somatosensory input and weakness significantly contribute to problems with community ambulation, balance and fear of falling in people with chronic stroke. Specific foot and ankle impairments may also negatively contribute to perceptions of physical appearance and self-esteem. Therapeutic management approaches within clinical practice appear to focus mostly on the gross performance of the lower limb with little emphasis on the specific assessment or treatment of the foot or ankle.
  
  
  CONCLUSIONS
  Foot pain, sensory impairments and muscle weakness in the foot and ankle can impact on community ambulation, balance and fear of falling following stroke. Foot and ankle function post-stroke should be routinely assessed and monitored. Clinicians should be aware of the potentially distressing negative perceptions associated with altered gait patterns, footwear and orthotic use.
authors.affiliation: a School of Health Professions, Plymouth University , Plymouth, Devon , UK .
authors.forename: Terry
authors.initials: T
authors.lastname: Gorst
authors.affiliation: b School of Health, Sport & Bioscience, University of East London , London , UK , and.
authors.forename: Alison
authors.initials: A
authors.lastname: Lyddon
authors.affiliation: a School of Health Professions, Plymouth University , Plymouth, Devon , UK .
authors.forename: Jon
authors.initials: J
authors.lastname: Marsden
authors.affiliation: a School of Health Professions, Plymouth University , Plymouth, Devon , UK .
authors.forename: Joanne
authors.initials: J
authors.lastname: Paton
authors.affiliation: b School of Health, Sport & Bioscience, University of East London , London , UK , and.
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Morrison
authors.affiliation: c Department of Allied Health Professions , University of the West of England , Bristol , UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Cramp
authors.affiliation: a School of Health Professions, Plymouth University , Plymouth, Devon , UK .
authors.forename: Jenny
authors.initials: J
authors.lastname: Freeman
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000842:Ankle / Q000503:physiopathology*; D005239:Fear; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005684:Gait; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology; D004856:Postural Balance; D036301:Qualitative Research; D000071939:Stroke Rehabilitation; D017741:Survivors / Q000523:psychology*; D016138:Walking
keywords: Balance; fear of falls; foot and ankle; mobility; stroke