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Yiu, Jeanne - Abstract

Background:  Self-efficacy has been suggested to be a strong predictor of disability and quality of life following stroke.1 Previous studies of older adults have found that those with lower balance related self-efficacy or balance confidence (BC) tend to decline more in their function and health.2, 3 Little is known about how BC varies in individuals post stroke and no study has used a non-disabled comparison.

Purpose: The objective of this study was to investigate the longitudinal relationship between BC and other performance and contextual variables.

Methods: This was a prospective cohort study of individuals with a first ever stroke and age- and sex- matched controls. Subjects were assessed at baseline (1 month post discharge from rehabilitation for stroke), 3, 6, and 12 months after baseline. BC, balance and mobility performance, psychological function, and important contextual variables were measured. A hierarchical linear model was developed to analyze how BC changes over time and if initial status or rate of change is associated with performance measures and contextual variables.

Results: 98 subjects with stroke and 98 controls participated. There was a slow natural improvement in balance confidence over 1 year in individuals with stroke but balance confidence remained significantly lower in these individuals compared to controls (p<0.001). Stroke status remained as the most important predictor of balance confidence even after controlling for covariates (p<0.001) accounting for 45.90% of the between-person variance in balance confidence.

Conclusions: Reduced balance confidence is a persistent and serious problem in individuals with stroke. Clinicians working in stroke rehabilitation should incorporate assessment and treatment for reduced balance confidence into their rehabilitation regime.

  1. LeBrasseur, N.K., Sayers, S.P., Ouellette, M.M., Fielding, R.A. (2006). Muscle impairments and behavioral factors mediate functional limitations and disability following stroke. Physical Therapy, 86(10), 1342-1350.
  2. Cumming, R.G., Salkeld, G., Thomas, M., Szonyi, G. (2000). Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. Journal of Gerontology: Medical Sciences, 55A(5), M299-M305.
  3. Tinetti, M.E., Mendes de Leon, C.F., Doucette, J.T., Baker, D.I. (1994). Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. Journal of Gerontology: Medical Sciences, 49(3), M140-M147.

International Award Winners: Zwicker, J., Chen, S.,  Faradaji, F., Gaudet, A., Hewapathirane, S., Inskip, J., Mikhail, D., Mills, P., Ramer, L., Simonette, G.
National Award Winners: Beirnes, K., Bundon, A., Hume, A., Lige, S., Schiarti, V.

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