title: Balance Confidence Is Related to Features of Balance and Gait in Individuals with Chronic Stroke.
abstract: BACKGROUND
  Reduced balance confidence is associated with impairments in features of balance and gait in individuals with subacute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify the relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke.
  
  
  METHODS
  Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months postdischarge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable, and quiet standing, walking, and reactive stepping outcome measures as the dependent variables.
  
  
  RESULTS
  Walking velocity was positively correlated with balance confidence, whereas mediolateral center of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence.
  
  
  CONCLUSIONS
  This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs.
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada. Electronic address: alisons@nipissingu.ca.
authors.forename: Alison
authors.initials: A
authors.lastname: Schinkel-Ivy
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Wong
authors.affiliation: Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Avril
authors.initials: A
authors.lastname: Mansfield
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010465:Perception; D004856:Postural Balance / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires
keywords: Chronic stroke; balance confidence; balance control; quiet standing; reactive balance; walking