Balance Self-Efficacy and Its Relevance to Physical Function and Perceived Health Status After Stroke

Salbach NM, Mayo NE, Robichaud-Ekstrand S, Hanley JA, Richards CL, Wood-Dauphinee S. Balance self-efficacy and its relevance to physical function and perceived health status after stroke.ObjectivesTo 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.DesignSecondary analysis of baseline, postintervention, and 6-month follow-up data from a randomized trial.SettingGeneral community.ParticipantsNinety-one subjects with a first or recurrent stroke, discharged from rehabilitation therapy with a residual walking deficit.InterventionsNot applicable.Main Outcome MeasuresThe 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.ResultsAverage 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.ConclusionsSubjects 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.