Theoretical Framework

 Substantive reviews of the literature were completed. The literature pertaining to

post-stroke mobility, gait speed, falls, and fear of falling were incorporated into the ICF

model (see Figure 1-2). It was used to guide the research questions and analyses for these

studies.

 In this study, the general health condition was "stroke." The type of stroke and

severity of stroke are important aspects that may impact post-stroke mobility. Stroke

related body function and body structure included sensory, cognitive, and motor

impairments. Environmental factors included caregiver depression, burden, and coping.

Personal factors included age, race, and cognition. These stroke related impairments and

personal factors might be related to activity limitations; such as difficulties completing

ADLs and IADLs, including walking, stair climbing, dressing, bathing, toileting, etc.

Mobility is a construct of ADLs and is therefore considered an aspect of activity. Gait

speed and fear of falling are each aspects of post-stroke mobility, and are therefore

considered as activity. It is thought that losses in gait speed and the development of fear

of falling adversely impact ADLs, IADLs, and social participation. Body function and

structure impairments and especially activity limitations may restrict participation in

society, thereby limiting role fulfillment at home, work, and within the social

environment. All of these post-stroke changes may also influence caregiver burden,

coping, depression.

 The current study was developed to specifically address the relationships between

changes in gait speed and the development of fear of falling with ADLs, IADLs,

participation, and depression. All aspects of the model may be affected by post-stroke

mobility. Activity, participation, and environmental/personal factors must therefore be