title: Fear Avoidance Behavior, Not Walking Endurance, Predicts the Community Reintegration of Community-Dwelling Stroke Survivors.
abstract: OBJECTIVE
  To examine the contribution of walking endurance, subjective balance confidence, and fear avoidance behavior to community reintegration among community-dwelling stroke survivors.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University-based rehabilitation center.
  
  
  METHODS
  Patients with chronic stroke (N=57) aged ≥50 years.
  
  
  METHODS
  None.
  
  
  METHODS
  The Chinese version of the Community Integration Measure (CIM).
  
  
  RESULTS
  Our correlation analyses revealed that fear avoidance behavior as measured by the Chinese version of the Survey of Activities and Fear of Falling in the Elderly (SAFE) scores had the highest significant negative correlation with CIM scores among all the variables tested. Our regression analyses also revealed that walking endurance and subjective balance confidence were not significant predictors of CIM scores. Based on scores on the number of falls in the previous 6 months, Chinese version of the Geriatric Depression Scale scores, distance covered in the 6-minute walk test, and Chinese versions of the Activities-specific Balance Confidence Scale scores and SAFE scores, our final regression model predicted 49.7% of the variance in the Chinese version of the CIM scores.
  
  
  CONCLUSIONS
  The levels of walking endurance and subjective balance confidence are not significant predictors of community reintegration of community-dwelling stroke survivors but the fear avoidance behavior. Future studies addressing fear avoidance behavior is clearly warranted for stroke rehabilitation.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR); School of Science and Technology, The Open University of Hong Kong, Ho Man Tin, Hong Kong (SAR).
authors.forename: Tai-Wa
authors.initials: TW
authors.lastname: Liu
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR). Electronic address: Shamay.Ng@polyu.edu.hk.
authors.forename: Shamay S
authors.initials: SS
authors.lastname: Ng
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR).
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Kwong
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR).
authors.forename: Gabriel Y
authors.initials: GY
authors.lastname: Ng
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000367:Age Factors; D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D004856:Postural Balance; D012047:Rehabilitation Centers; D012111:Residence Characteristics; D012737:Sex Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D016138:Walking
keywords: Fear; Rehabilitation; Stroke