Abstract
Background:
Persistent deficits in arm function are common after stroke. An
improved understanding of the factors that contribute to the performance
of skilled arm movements is needed. One such factor may be
self-efficacy (SE).
Objective: To determine the level of SE for
skilled, goal-directed reach actions in individuals with mild motor
impairment after stroke and whether SE for reach performance correlated
with actual reach performance.
Methods:
A total of 20 individuals
with chronic stroke (months poststroke: mean 58.1 ± 38.8) and mild
motor impairment (upper-extremity Fugl-Meyer [FM] motor score: mean
53.2, range 39 to 66) and 6 age-matched controls reached to targets
presented in 2 directions (ipsilateral, contralateral). Prior to each
block (24 reach trials), individuals rated their confidence on reaching
to targets accurately and quickly on a scale that ranged from 0 (not very confident) to 10 (very confident).
Results:
Overall reach performance was slower and less accurate in the
more-affected arm compared with both the less-affected arm and controls.
SE for both reach speed and reach accuracy was lower for the
more-affected arm compared with the less-affected arm. For reaches with
the more-affected arm, SE for reach speed and age significantly
predicted movement time to ipsilateral targets (R2 = 0.352), whereas SE for reach accuracy and FM motor score significantly predicted end point error to contralateral targets (R2 = 0.291).
Conclusions:
SE relates to measures of reach control and may serve as a target for
interventions to improve proximal arm control after stroke.
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