title: Muscle impairments and behavioral factors mediate functional limitations and disability following stroke.
abstract: OBJECTIVE
  Stroke remains the leading cause of disability in the United States. The purposes of this study were to examine whether quantitative measures of muscle strength and power in the involved lower extremity predict functional limitations and to evaluate the contributions of behavioral factors to mediating disability and quality of life in people who have survived a stroke.
  
  
  METHODS
  A cross-sectional study design was used, and measurements of muscle impairment, lower-body function, disability, quality of life, and behavioral factors were obtained for 31 community-dwelling volunteers who had experienced a single ischemic stroke in the past 6 to 24 months.
  
  
  RESULTS
  Stepwise regression models including impairment and behavioral measures were strong predictors of function, disability, and quality of life. Involved-extremity muscle strength and power and self-efficacy were independently associated with function, whereas depression and self-efficacy were strong predictors of disability and quality of life.
  
  
  CONCLUSIONS
  The findings warrant future studies to determine whether interventions that address muscle strength and power, depressive symptoms, and low self-efficacy effectively improve function, reduce disability, and enhance quality of life in people who have survived a stroke.
authors.affiliation: Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02118, USA. nlebrass@bu.edu
authors.forename: Nathan K
authors.initials: NK
authors.lastname: LeBrasseur
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Sayers
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Ouellette
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression; D004185:Disability Evaluation; D005260:Female; D005684:Gait; D006801:Humans; D007537:Isometric Contraction; D007866:Leg; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D018908:Muscle Weakness / Q000209:etiology; D011788:Quality of Life; D012044:Regression Analysis; D020377:Self Efficacy; D020521:Stroke / Q000150:complications / Q000523:psychology; D000071939:Stroke Rehabilitation; D014481:United States