Article

OBJECTIVES: To (1) examine the relationships between multiple poststroke mobility
variables (gait speed, walking capacity, balance, balance self-efficacy, and
falls self-efficacy) and activity and participation; and (2) determine which
poststroke mobility variables are independently associated with activity and
participation. DESIGN: This is the primary analysis of a prospective
cross-sectional study completed to understand the impact of mobility on activity
and participation in people with chronic stroke. SETTING: University-based
research laboratory, hospitals, and stroke support groups. PARTICIPANTS: People
(N=77) with stroke greater than 6 months ago were included in the study if they
were referred to occupational or physical therapy for physical deficits as a
result of the stroke, completed all stroke related inpatient rehabilitation, had
residual functional disability, scored a >/=4 out of 6 on the short, 6-item
Mini-Mental State Examination, and were between the ages of 50 and 85.
INTERVENTIONS: Not applicable, this is a cross-sectional data collection of 1
timepoint. MAIN OUTCOME MEASURES: We measured activity and participation with the
validated International Classification of Functioning, Disability and Health
Measure of Participation and Activities. Other variables included gait speed
(10-meter walk), walking capacity (6-minute walk), balance (Berg Balance Scale),
balance self-efficacy (Activities Specific Balance Confidence Scale), and falls
self-efficacy (Modified Falls Efficacy Scale). RESULTS: Only balance
self-efficacy was found to be independently associated with poststroke activity
(beta=-.430, P<.022, 95% confidence interval [CI], -.247 to -.021) and
participation (beta=-.439, P<.032, 95% CI, -.210 to -.010). CONCLUSIONS: Among
people with chronic stroke, balance self-efficacy, not physical aspects of gait,
was independently associated with activity and participation. While gait training
continues to be important, this study indicates a need to further evaluate and
address the psychological factors of balance and falls self-efficacy to obtain
the best stroke recovery.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS