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 RehabilitationBalance 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 abilityIt would be appropriate to assess the balance efficacy as well as balance ability for maximizing performing tasks such as ADLs for individual with strokeInterventions 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