Nancy M. Salbach received a fellowship from the Canadian Institutes of Health Research to conduct this study. Operating funds were provided by the Quebec Réseau provincial de recherche en adaptation-réadaptation, the Heart and Stroke Foundation of Canada, and the Canadian Stroke Network.
The Effect of a Task-Oriented Walking Intervention on Improving Balance Self-Efficacy Poststroke: A Randomized, Controlled Trial
Article first published online: 30 MAR 2005
Journal of the American Geriatrics Society
Volume 53, Issue 4, pages 576–582, April 2005
How to Cite
Salbach, N. M., Mayo, N. E., Robichaud-Ekstrand, S., Hanley, J. A., Richards, C. L. and Wood-Dauphinee, S. (2005), The Effect of a Task-Oriented Walking Intervention on Improving Balance Self-Efficacy Poststroke: A Randomized, Controlled Trial. Journal of the American Geriatrics Society, 53: 576–582. doi: 10.1111/j.1532-5415.2005.53203.x
- Issue published online: 30 MAR 2005
- Article first published online: 30 MAR 2005
- cerebrovascular accident;
- controlled trial;
Objectives: To evaluate the efficacy of a task-oriented walking intervention in improving balance self-efficacy in persons with stroke and to determine whether effects were task-specific, influenced by baseline level of self-efficacy and associated with changes in walking and balance capacity.
Design: Secondary analysis of a two-center, observer-blinded, randomized, controlled trial.
Setting: General community.
Participants: Ninety-one individuals with a residual walking deficit within 1 year of a first or recurrent stroke.
Intervention: Task-oriented interventions targeting walking or upper extremity (UE) function were provided three times a week for 6 weeks.
Measurements: Activities-specific Balance Confidence Scale, Six-Minute Walk Test, 5-m walk, Berg Balance Scale, and Timed “Up and Go” administered at baseline and postintervention.
Results: The walking intervention was associated with a significantly greater average proportional change in balance self-efficacy than the UE intervention. Treatment effects were largest in persons with low self-efficacy at baseline and for activities relating to tasks practiced. In the walking group, change in balance self-efficacy correlated with change in functional walking capacity (correlation coefficient=0.45, 95% confidence interval=0.16–0.68). Results of multivariable modeling suggested effect modification by the baseline level of depressive symptoms and a prognostic influence of age, sex, comorbidity, time poststroke, and functional mobility on change in self-efficacy.
Conclusion: Task-oriented walking retraining enhances balance self-efficacy in community-dwelling individuals with chronic stroke. Benefits may be partially the result of improvement in walking capacity. The influence of baseline level of self-efficacy, depressive symptoms, and prognostic variables on treatment effects are of clinical importance and must be verified in future studies.