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Huynh E, Wiley E, Park S, Sakakibara BM, Tang A. Examining the association between balance self-efficacy and virtual balance performance in individuals with stroke: a cross-sectional study. Top Stroke Rehabil 2024:1-9. [PMID: 38785298 DOI: 10.1080/10749357.2024.2356407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/27/2024] [Indexed: 05/25/2024]
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.
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Affiliation(s)
- Eric Huynh
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Sarah Park
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, The University of British Columbia, Kelowna, Canada
| | - Brodie M Sakakibara
- Centre for Chronic Disease Prevention and Management, Faculty of Medicine, The University of British Columbia, Kelowna, Canada
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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Kabboord AD, Godfrey D, Gordon AL, Gladman JRF, Van Eijk M, van Balen R, Achterberg WP. The modified functional comorbidity index performed better than the Charlson index and original functional comorbidity index in predicting functional outcome in geriatric rehabilitation: a prospective observational study. BMC Geriatr 2020; 20:114. [PMID: 32223742 PMCID: PMC7104537 DOI: 10.1186/s12877-020-1498-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background In the inpatient rehabilitation of older patients, estimating to what extent the patient may functionally recover (functional prognosis), is important to plan the rehabilitation programme and aid discharge planning. Comorbidity is very common in older patients. However, the role of comorbidity in making a functional prognosis is not clearly defined. The aim of this study was to investigate a modified and weighted Functional Comorbidity Index (w-FCI) in relation to functional recovery and compare its predictive performance with that of the Charlson comorbidity index (CCI) and the original Functional Comorbidity Index (FCI). Methods The COOPERATION study (Comorbidity and Outcomes of Older Patients Evaluated in RehabilitATION) is a prospective observational cohort study. Data of patients that were admitted in an inpatient geriatric rehabilitation facility in the UK between January and September 2017, were collected. The outcome measures were: the Elderly Mobility Scale (EMS) and Barthel index (BI) at discharge, EMS gain/day and BI gain/day. Baseline comorbidity was assessed using the CCI, the FCI and the w-FCI. Correlations, receiver operating curves (ROC), and multiple linear regression analyses were performed. The models were adjusted for age, gender and EMS or BI on admission. Results In total, 98 patients (mean age 82 years; 37% male) were included. The areas under the ROC curves of the w-FCI (EMS at discharge: 0.72, EMS gain/day: 0.72, BI at discharge: 0.66 and BI gain/day: 0.60) were higher than for the CCI (0.50, 0.53, 0.49, 0.44 respectively) and FCI (0.65, 0.55, 0.60, 0.49 respectively). The w-FCI was independently associated with EMS at discharge (20.7% of variance explained (PVE), p < 0.001), EMS gain/day (11.2PVE, p < 0.001), and BI at discharge (18.3 PVE, p < 0.001). The FCI was only associated with EMS gain/day (3.9 PVE, p < 0.05). None of the comorbidity indices contributed significantly to BI gain/day (w-FCI: 2.4 PVE, p > 0.05). Conclusions The w-FCI was predictive of mobility & function at discharge and mobility gain per day, and outperformed the original FCI and the CCI. The w-FCI could be useful in assessing comorbidity in a personalised way and aid functional prognosis at the start of rehabilitation.
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Affiliation(s)
- Anouk D Kabboord
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands.
| | - Deborah Godfrey
- Lings Bar Hospital, Nottingham Healthcare NHS Trust, Nottingham, UK
| | - Adam L Gordon
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, UK.,Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.,CLAHRC East Midlands, Nottingham, UK.,University Hospitals of Derby and Burton University Hospitals NHS Foundation Trust, Derby, UK
| | - John R F Gladman
- Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.,CLAHRC East Midlands, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Monica Van Eijk
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands.,Department of Old-Age Medicine Hubertusduin, HMC Bronovo, The Hague, the Netherlands
| | - Romke van Balen
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Postbus 9600, 2300, RC, Leiden, the Netherlands
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