Perceived importance of walking among hospitalized patients with stroke: a thematic analysis

Introduction: Improved walking ability is a common rehabilitation goal for individuals following a stroke. However, the reasons why hospitalized individuals with stroke consider walking to be important are not yet fully understood. This study aimed to elucidate the perceived importance of walking among hospitalized patients with stroke. Methods: This qualitative study employed thematic analysis. Hospitalized individuals with stroke undergoing gait rehabilitation were purposively sampled to capture variation in sex, age, and walking ability. The participants underwent in-person semi-structured interviews regarding the importance of walking, which were audio-recorded, transcribed verbatim, and systematically coded to generate themes. Results: A total of 19 patients participated in the study. Thematic analysis revealed six major themes. (1) Resumption of daily life: walking was perceived as essential for returning to pre-stroke activities and routines. (2) Health promotion and prevention of functional decline: participants viewed walking as important for maintaining health and preventing deterioration. (3) Uncomfortable walking: participants described physical and environmental challenges associated with walking. (4) Relationships with others: concerns were expressed about how walking difficulties might affect relationships with family and others. (5) Labeling of decreased walking ability: participants were conscious of how their walking was perceived by others. (6) Social environment: walking was linked to broader social factors such as work and transportation. Conclusion: The importance of walking for hospitalized patients with stroke ranges from impersonal and generalizable reasons to highly individualized and diverse factors, with implications for individualized walking rehabilitation.