Relationship Between Walking Capacity, Biopsychosocial Factors, Self-efficacy, and Walking Activity in Persons Poststroke

What is your doctor doing with this to update your stroke protocols? Or are you once again on your own doing your doctors job? You will notice that there was no attempt to objectively identify dead and damaged areas in the brain. Research that will be impossible to replicate and compare results.
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Danks, Kelly A. PT, DPT; Pohlig, Ryan T. PhD; Roos, Margie PT, DPT, PhD; Wright, Tamara R. PT, DPT; Reisman, Darcy S. PT, PhD

Journal of Neurologic Physical Therapy
October 2016
Vol. 40 - Issue 4: p 232–238

Abstract

Background/Purpose: Many factors appear to be related to physical activity after stroke, yet it is unclear how these factors interact and which ones might be the best predictors. Therefore, the purpose of this study was twofold: (1) to examine the relationship between walking capacity and walking activity, and (2) to investigate how biopsychosocial factors and self-efficacy relate to walking activity, above and beyond walking capacity impairment poststroke.

Methods: Individuals greater than 3 months poststroke (n = 55) completed the Yesavage Geriatric Depression Scale (GDS), Fatigue Severity Scale (FSS), Modified Cumulative Illness Rating (MCIR) Scale, Walk 12, Activities-Specific Balance Confidence (ABC) Scale, Functional Gait Assessment (FGA), and oxygen consumption testing. Walking activity data were collected via a StepWatch Activity Monitor. Predictors were grouped into 3 constructs: (1) walking capacity: oxygen consumption and FGA; (2) biopsychosocial: GDS, FSS, and MCIR; (3) self-efficacy: Walk 12 and ABC. Moderated sequential regression models were used to examine what factors best predicted walking activity.

Results: Walking capacity explained 35.9% (P < 0.001) of the variance in walking activity. Self-efficacy (ΔR² = 0.15, P < 0.001) and the interaction between the FGA×ABC (ΔR² = 0.047, P < 0.001) significantly increased the variability explained. The FGA (β = 0.37, P = 0.01), MCIR (β = -0.26, P = 0.01), and Walk 12 (β = −0.45, P = 0.00) were each individually significantly associated with walking activity.

Discussion and Conclusion: Although measures of walking capacity and self-efficacy significantly contributed to “real-world” walking activity, balance self-efficacy moderated the relationship between walking capacity and walking activity. Improving balance self-efficacy may augment walking capacity and translate to improved walking activity poststroke.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A139).

What does research reproducibility mean?

I'd be willing to bet that none of the clinical stroke research trials since forever are reproducible or replicable.  Because they don't have an objective starting point of exact description of the size and location of the dead/damaged areas.
Definitions from Retraction Watch
Here’s how the US National Science Foundation (NSF) defines “reproducibility,” according to the authors:

…reproducibility refers to the ability of a researcher to duplicate the results of a prior study using the same materials as were used by the original investigator. That is, a second researcher might use the same raw data to build the same analysis files and implement the same statistical analysis in an attempt to yield the same results…. Reproducibility is a minimum necessary condition for a finding to be believable and informative.

And here’s how the NSF defines “replicability,” the authors say:

…the ability of a researcher to duplicate the results of a prior study if the same procedures are followed but new data are collected.

What does research reproducibility mean?

1. Steven N. Goodman*,
2. Daniele Fanelli and
3. John P. A. Ioannidis

+ Author Affiliations

1. ↵*Corresponding author. Email: steve.goodman@stanford.edu

Science Translational Medicine  01 Jun 2016:
Vol. 8, Issue 341, pp. 341ps12
DOI: 10.1126/scitranslmed.aaf5027

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Abstract

The language and conceptual framework of “research reproducibility” are nonstandard and unsettled across the sciences. In this Perspective, we review an array of explicit and implicit definitions of reproducibility and related terminology, and discuss how to avoid potential misunderstandings when these terms are used as a surrogate for “truth.”