Balance self-efficacy and its relevance to physical function and perceived health status after stroke

Nancy M Salbach, Nancy E Mayo, Sylvie Robichaud-Ekstrand, James A Hanley, Carol L Richards, Sharon Wood-Dauphinee
Archives of Physical Medicine and Rehabilitation 2006, 87 (3): 364-70

OBJECTIVES: To estimate the level of balance self-efficacy among community-dwelling subjects with stroke and to determine the relative importance of balance self-efficacy compared with functional walking capacity in predicting physical function and perceived health status.

DESIGN: Secondary analysis of baseline, postintervention, and 6-month follow-up data from a randomized trial.

SETTING: General community.

PARTICIPANTS: Ninety-one subjects with a first or recurrent stroke, discharged from rehabilitation therapy with a residual walking deficit.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: The Activities-Specific Balance Confidence (ABC) Scale, Medical Outcomes Study 36-Item Short-Form Health Survey physical function scale, and the EQ-5D visual analog scale of perceived health status.

RESULTS: Average balance self-efficacy was 59 out of 100 points on the ABC scale (95% confidence interval, 55-64; n=89). After adjusting for age and sex, functional walking capacity explained 32% and 0% of the respective variability in physical function and perceived health status scores obtained 6 months later. After adjustment for age, sex, and functional walking capacity, balance self-efficacy explained 3% and 19% of variation in 6-month physical function and perceived health status scores, respectively.

CONCLUSIONS: Subjects living in the community after stroke experience impaired balance self-efficacy. Enhancing balance self-efficacy in addition to functional walking capacity may lead to greater improvement, primarily in perceived health status, but also in physical function, than the enhancement of functional walking capacity alone.

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