Balance self-efficacy in relation to balance and activities of daily living in community residents with stroke

Purpose: This study attempts to determine a causal relationship among balance self-efficacy, balance, and activities of daily living (ADL) in community residents with stroke.

Method: A cross-sectional descriptive correlation study was conducted with a convenience sample comprising 105 stroke patients living in the community. Data were collected using self-reporting questionnaires, including the Activities-specific Balance Confidence (ABC) scale and the Korean version of the Modified Barthel Index (K-MBI). The Berg Balance Scale was used to measure balance ability. A path model was tested to investigate the causal relations between variables, using the AMOS 17.0 statistical program to analyze the models, to obtain maximum-likelihood estimates of model parameters and to provide goodness-of-fit indices.

Results: The proposed path model showed good fit indices. The direct path was significant between balance self-efficacy and balance (0.583), between balance and ADL (0.455). The indirect path was significant between balance self-efficacy and ADL (0.015).

Conclusion: Our results support the link between balance efficacy, balance, and ADL in stroke patients. The proposed conceptual model was a good fit for the data and provided a plausible framework for understanding the relationship among these factors in stroke patients. Our model may also guide the intervention of functional rehabilitation for stroke patients.

Implications for Rehabilitation:

• Balance self-efficacy, a psychological factor, should not be overlooked in attempting to improve functional outcomes in stroke survivors because balance self-efficacy impact ADL through the mediation of balance ability
• It would be appropriate to assess the balance efficacy as well as balance ability for maximizing performing tasks such as ADLs for individual with stroke
• Interventions that use a combination of balance training and balance self-efficacy enhancement could be the most effective for improving ADL in the case of community-dwelling stroke patients

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