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 positively related with 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) test, Tandem Stand test, and Functional Reach test (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 virtually administered by trained physical therapists through videoconferencing software. Hierarchal multivariate regression analyses were used to examine the associations between the ABC scale and TUG test, Tandem Stand test and FRT, while adjusting for age and number of comorbidities. Results. Fifty-one participants (n=11 female, median age=64 [IQR:18] years, 9.3  4.6 months poststroke) were included in the analyses. ABC scores were associated with TUG times (R2=0.56, F(3,47)=20.26, p<0.01), but not Tandem Stand scores (R2=0.18, F(5,45)=1.93, p=0.11) or FRT distances (R2=0.14, F(3,47)=2.55, p=0.07). Conclusion. We observed associations between the ABC scale scores and virtual TUG, but not with virtual 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 and ABC in stroke.