Examining the association between balance self-efficacy and virtual balance performance in individuals with stroke: a cross-sectional study

ABSTRACT

Background

Balance self-efficacy is a strong predictor of fall risk after stroke and is related to performance on balance and walking tests. The use of telerehabilitation for delivering stroke rehabilitation has increased in recent years and there is a need to adapt common clinical assessments to be administered in virtual formats, but the association between balance self-efficacy and virtually administered clinical tests of balance performance has yet to be established. This study examined the association between the Activities-specific Balance Confidence (ABC) Scale and virtually administered Timed Up and Go (TUG), Tandem Stand, and Functional Reach tests (FRT) in individuals with stroke.

Methods

This was a secondary analysis of baseline data from two telerehabilitation trials with individuals with stroke. All assessments were administered by trained physical therapists through videoconferencing software. Multivariate regression analyses were used to examine the associations between the ABC scale and TUG test, Tandem Stand test, and FRT, adjusted for age and number of comorbidities.

Results

Data from 51 participants (n = 11 female, median age = 64 [IQR: 18] years, 9.3 ± 4.6 months poststroke) were analyzed. The ABC scores were associated with TUG (R² = 0.56, F(3,47) = 20.26, p < 0.01), but not Tandem Stand (R² = 0.18, F(5,45) = 1.93, p = 0.11) or FRT (R² = 0.14, F(3,47) = 2.55, p = 0.07) tests.

Conclusion

We observed associations between the ABC scores and virtual TUG, but not with Tandem Stand or FRT, which may be attributed to the context-specificity of balance self-efficacy. As virtual administration of outcomes assessments becomes part of common practice in stroke rehabilitation, our study supports the use of virtually administered TUG in stroke.

KEYWORDS:

• Stroke
• postural balance
• telerehabilitation
• virtual rehabilitation
• self-efficacy
• outcome assessment

Acknowledgments

This work was supported by the CanStroke Recovery Trials Platform for the recruitment of these trials and the Brain Canada Foundation for their support of the Platform, and by the Canadian Institutes of Health Research (PJI 175440, PNN 177929, PJT-178201). Funding for the Canstroke Recovery Trials Platform has been made possible by the Canada Brain Research Fund (CBRF), an innovative arrangement between the Government of Canada (through Health Canada) and Brain Canada Foundation and the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery. EH was supported by a Canadian Institute for Health Research-Masters (CIHR CGSM) Scholarship. EW was supported by an Ontario Graduate Scholarship. SP was supported by a CIHR CGSM Scholarship. BMS was supported by a Michael Smith Health Research BC Scholar Award and a Heart and Stroke Foundation of Canada National New Investigator Award. AT was supported by a Clinician-Scientist Award (Phase II) from the Ontario Heart & Stroke Foundation (P-19-TA-1192). Study funders had no role in the study design, collection, management, analysis, or interpretation of data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.