Balance self-efficacy and its relevance to physical function and perceived health status after stroke

Objectives: To 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. Design: Secondary analysis of baseline, postintervention, and 6-month follow-up data from a randomized trial. Setting: General community. Participants: Ninety-one subjects with a first or recurrent stroke, discharged from rehabilitation therapy with a residual walking deficit. Interventions: Not applicable. Main Outcome Measures: The 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. Results: Average 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. Conclusions: Subjects 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.