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On self-efficacy and balance after stroke
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Neuroscience.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this work was to evaluate the outcome of specialised stroke rehabilitation and to examine the relation between both subjectively perceived and objectively assessed balance and impairments and some activity limitations. A further, integrated aim was to establish some psychometric properties and the usability of a newly developed Falls-Efficacy Scale, Swedish version (FES(S)) in stroke rehabilitation.

Seventy-three patients younger than 70 years of age with a first stroke and reduced walking ability were randomised into an intervention group (walking on a treadmill with body weight support) and a control group (walking on the ground). Time points of assessment were: on admission for rehabilitation, at discharge and 10 months after stroke. Walking training on a treadmill with body weight support and walking training on the ground were found to be equally effective in the early rehabilitation. The patients in both groups improved their walking velocity, motor function, balance, self-efficacy and ADL performance.

In a geriatric sample of 37 stroke patients examined at similar time points, significant improvements in self-efficacy, motor function, balance, ambulation and ADL occurred from admission to discharge independently of age. In comparison with observer-based balance measures, FES(S) at discharge was the most powerful predictor of ADL performance 10 months after onset of stroke.

In 30 patients with stable stroke, the overall test-retest reliability of FES(S) was found to be adequate. The internal consistency confirmed that FES(S) has an adequate homogeneity.

In a subsample of 62 patients from the original sample and in the geriatric sample, FES(S) correlated significantly with Berg’s balance scale, the Fugl-Meyer balance scale, with motor function and with gait performance. In the relatively younger group ADL (measured by the Functional Independence Measurement) correlated significantly with FES(S) on admission and at 10 months follow-up, while at discharge none of the FES(S) measures correlated significantly with ADL. In this subsample effect size statistics for detecting changes in FES(S) demonstrated very acceptable responsiveness of this scale during the early treatment period and during the total observation period

In the light of these findings assessment and treatment of self-efficacy seems relevant in stroke rehabilitation.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2002. , p. 60
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1112
Keywords [en]
Neurosciences, Cerebrovascular disorders, rehabilitation, physiotherapy, balance, self-efficacy, treadmill walking, activities of daily living
Keywords [sv]
Neurovetenskap
National Category
Neurology
Research subject
Rehabilitation Medicine
Identifiers
URN: urn:nbn:se:uu:diva-1615ISBN: 91-554-5206-X (print)OAI: oai:DiVA.org:uu-1615DiVA, id: diva2:161202
Public defence
2002-02-01, Grönwallsalen, Uppsala, 13:15
Opponent
Available from: 2002-01-10 Created: 2002-01-10Bibliographically approved
List of papers
1. Walking training of patients with hemiparesis at an early stage after stroke: A comparison of walking training on a treadmill with body weight support and walking training on the ground
Open this publication in new window or tab >>Walking training of patients with hemiparesis at an early stage after stroke: A comparison of walking training on a treadmill with body weight support and walking training on the ground
Show others...
2001 In: Clin Rehabil, Vol. 15, p. 515-527Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-89582 (URN)
Available from: 2002-01-10 Created: 2002-01-10Bibliographically approved
2. Fear of falling in patients with stroke: A reliability study
Open this publication in new window or tab >>Fear of falling in patients with stroke: A reliability study
1999 In: Clin Rehabil, Vol. 13, p. 509-517Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-89583 (URN)
Available from: 2002-01-10 Created: 2002-01-10Bibliographically approved
3. Relationship of confidence in task performance with balance and motor function after stroke
Open this publication in new window or tab >>Relationship of confidence in task performance with balance and motor function after stroke
2001 In: Physiother Theory Pract, Vol. 17, p. 55-65Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-89584 (URN)
Available from: 2002-01-10 Created: 2002-01-10Bibliographically approved
4. The Falls-Efficacy Scale, Swedish version: does it reflect clinically meaningful changes after stroke?
Open this publication in new window or tab >>The Falls-Efficacy Scale, Swedish version: does it reflect clinically meaningful changes after stroke?
2002 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, no 9, p. 471-481Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

The overall aim of this prospective investigation was to evaluate the ability of the Falls Efficacy Scale (Swedish version) (FES(S)) to reflect clinically meaningful changes over time.

METHOD:

Changes on the FES(S) scale were compared with changes in two different standardized measures of observer-assessed balance, the Berg Balance Scale (BBS), the Fugl-Meyer balance subscale (FMB), and of motor function and ambulation in 62 stroke patients. Assessments took place on admission for rehabilitation, at discharge and 10 months after the stroke. Indices of effect size were used to evaluate responsiveness of the instruments. Three time periods were studied: admission to discharge (early response), discharge to 10 month follow-up (late response) and admission to follow-up (overall response).

RESULTS:

The main findings are that the FES(S) is as responsive as BBS and FMB in detecting changes during the early and overall response periods. Changes in FES(S) scores between admission and discharge correlated significantly with changes in observer-assessed balance, motor function and ambulation scores.

CONCLUSIONS:

The present results suggest that measurement of perceived confidence in task performance using the FES(S) scale is responsive to improvement in patients with hemiparesis at an early stage after stroke.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89585 (URN)10.1080/09638280110105259 (DOI)12097216 (PubMedID)
Available from: 2002-01-10 Created: 2002-01-10 Last updated: 2017-12-14Bibliographically approved
5. Self-efficacy in relation to impairments and ADL disability in elderly stroke patients: A prospective investigation
Open this publication in new window or tab >>Self-efficacy in relation to impairments and ADL disability in elderly stroke patients: A prospective investigation
2003 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, no 5, p. 202-207Article in journal (Refereed) Published
Abstract [en]

Objectives: The objectives of this prospective study, under-taken in elderly patients with stroke undergoing rehabilita-tion, were to determine to what extent fall-related self-efficacy changes over time, its relationships to objectivelyassessed functions and activities, and the predictive capacityof self-efficacy at discharge for activities of daily living 10months after stroke.

Methods: The study comprised 37 patients, aged 66–89 years.Main outcome measurement instruments were the FallsEfficacy Scale (Swedish version), Berg Balance Scale andFunctional Independence Measure.

Results: Significant improvements occurred in all thesemeasures from admission to discharge, but patients with lowself-efficacy at discharge showed less pronounced improve-ments than those with high self-efficacy. Falls Efficacy Scale(Swedish version) was closely associated with all othermeasures and was a more powerful predictor of activities ofdaily living than the observer-based measures of balance.

Conclusion: To minimize dependence in activities of dailyliving, rehabilitation interventions should incorporate self-efficacy enhancement.

National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-89586 (URN)10.1080/16501970310000836 (DOI)14582550 (PubMedID)
Available from: 2002-01-10 Created: 2002-01-10 Last updated: 2017-12-14Bibliographically approved

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