http://nnr.sagepub.com/content/26/8/999.abstract?etoc
Abstract
Background. Confidence about balance may be an important factor affecting self-efficacy for daily activities after stroke. Objective. The authors investigated whether confidence changes and the parameters that may predict changes in self-perceived balance
within the first year of community reintegration. Methods.
In this prospective study, 98 hemiparetic participants who could walk
at least 10 m independently were assessed 1, 3, 6,
and 12 months postdischarge from rehabilitation by
the Berg Balance Scale, Timed Up and Go, 6-minute walking distance, and
depression and anxiety scales. The 98
age-/sex-matched controls were assessed at enrollment and the same
intervals. Multilevel
modeling was used to determine if assessed
covariates predicted changes in balance confidence by the
Activities-Specific Balance
Confidence Scale. Results. Stroke subjects
had lower initial balance confidence than controls and showed a
statistically significant increase in confidence
over 1 year at each assessment. Poor balance and
high state anxiety were associated with lower balance confidence.
Significant
interactions were observed between greater
depression, along with more impaired walking capacity and balance tests,
in predicting
lower change trajectories in confidence. Falls
predicted a reduced rate of improvement. Conclusions. Balance
confidence after stroke remained lower than controls over the first
year. Physical therapies and supportive interventions
designed to treat confidence should be initiated at
discharge from inpatient rehabilitation.
ya know... if you are frequently loosing your balance and getting hurt and then you still show "balance confidence" I am guessing you might qualify for other therapy to help you learn to accept the reality of your situation.
ReplyDeleteThat said (whined about) once I got in the pool and figured out that I would not get hurt falling in water my confidence in the aquatic physiotherapy improved so I was more willing to work on more challenging movements.
More safe exercise-- more improvement.. more fall confidence! Ta da.
That gets into the point, do you learn faster by analyzing why you fell or just practicing the stuff you already know how to do?. I bet Michael Jordan worked on impossible shots a lot more than layups.
DeleteI did wish the pool hadn't closed a couple of years earlier, but then I would have worried about drowning, with the inability to get my feet under me to stand up again.
Aww Dean.. the pool's therapists stay close by and they can put floaty things on you to keep you right side up!
DeleteThose Impossible shots are my goals.
Linda