title: The effect of a task-oriented walking intervention on improving balance self-efficacy poststroke: a randomized, controlled trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Secondary analysis of a two-center, observer-blinded, randomized, controlled trial.
  
  
  METHODS
  General community.
  
  
  METHODS
  Ninety-one individuals with a residual walking deficit within 1 year of a first or recurrent stroke.
  
  
  METHODS
  Task-oriented interventions targeting walking or upper extremity (UE) function were provided three times a week for 6 weeks.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Epidemiology and Biostatistics and Occupational Health, McGill University Montreal, Quebec, Canada. nancy.salbach@utoronto.ca
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Salbach
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Mayo
authors.forename: Sylvie
authors.initials: S
authors.lastname: Robichaud-Ekstrand
authors.forename: James A
authors.initials: JA
authors.lastname: Hanley
authors.forename: Carol L
authors.initials: CL
authors.lastname: Richards
authors.forename: Sharon
authors.initials: S
authors.lastname: Wood-Dauphinee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D004856:Postural Balance; D020377:Self Efficacy; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation; D016138:Walking