Balance and Balance Self-Efficacy Are Associated With Activity and Participation After Stroke: A Cross-Sectional Study in People With Chronic Stroke

Archives of Physical Medicine and Rehabilitation, 05/25/2012

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.


  • 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.
  • The authors 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).


  • Only balance self–efficacy was found to be independently associated with poststroke activity (β =–.430, P<.022, 95% confidence interval [CI], –.247 to –.021) and participation (β =–.439, P<.032, 95% CI, –.210 to –.010).

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