Factors affecting measures of activities and participation in persons with mobility impairment

Purpose. This study examined important factors affecting activities and participation of persons with mobility impairments. Method. This mixed methods study employed grounded theory approaches and data conversion to quantify impact of environmental and personal factors on standard measures of activities and participation. Semi-structured interviews of participants with mobility impairments were conducted to identify key factors and the magnitude of their influence on activities of daily living and participation. Participants were individually scored on the Barthel index (BI) and the Participation scale (P-scale); BI scores that would have been obtained without associated factors were estimated. Average cumulative impact of factors on BI and P-scale scores were estimated to identify factors with the greatest numeric impact. Results. Twenty-four participants identified 258 factors that impacted activities. For the BI, adaptive equipment, gait aids, wheelchairs, scooters and home modifications were most influential. For the P-scale, personality, community and home accessibility, level of impairment, mobility aids and transportation were among the most influential. Conclusion. Convergent results through various methods suggest that reporting of contextual factors that may affect scores on standardised measures of activities and participation may assist in interpretation, and identification of interventional needs at the individual or system levels.