Fear Avoidance Behavior, Not Walking Endurance, Predicts the Community Reintegration of Community-Dwelling Stroke Survivors

Liu, Tai Wa; Ng, Ssm; Kwong, Patrick W.H.; Ng, Gabriel Y.F.

doi:10.1016/j.apmr.2015.05.005

Cited by 23 publications

(16 citation statements)

References 41 publications

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“…Despite our studies having similar inclusion criteria, the results of this study are not consistent with the findings of Liu et al [ 42 ]. They reported that walking endurance measured by the 6MWT was not a significant predictor of the level of community integration ( β = 0.083, p = 0.469) in a sample of 57 chronic stroke survivors [ 42 ]. The differences between the findings of the two studies may be partly explained by the different outcome measures.…”

Section: Discussioncontrasting

confidence: 99%

“…It is plausible that good balance performance augments the level of self-efficacy in carrying out daily activities and participating in social life, as demonstrated in a previous study [ 41 ]. A fear of falling [ 42 ] and balance-related self-efficacy [ 5 ] were also found to be independent predictors of community integration in stroke survivors. Both factors were strongly associated with balance performance [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

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A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

Kwong

Chung

et al. 2017

PLoS ONE

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PurposeTo use structural equation modelling (SEM) to determine (1) the direct and indirect associations of strength of paretic lower limb muscles with the level of community integration, and (2) the direct association of walking endurance and balance performance with the level of community integration in community-dwelling stroke survivors.Materials and methodsIn this cross-sectional study of 105 stroke survivors, the Subjective Index of Physical and Social Outcome (SIPSO) was used to measure the level of community integration. Lower-limb strength measures included isometric paretic ankle strength and isokinetic paretic knee peak torque. The Berg Balance Scale (BBS) and the 6-minute walk test (6MWT) were used to evaluate balance performance and walking endurance, respectively.ResultsSEM revealed that the distance walked on the 6MWT had the strongest direct association with the SIPSO score (β = 0.41, p <0.001). An increase of one standard deviation in the 6MWT distance resulted in an increase of 0.41 standard deviations in the SIPSO score. Moreover, dorsiflexion strength (β = 0.18, p = 0.044) and the BBS score (β = 0.21, p = 0.021) had direct associations with the SIPSO score.ConclusionsThe results of the proposed model suggest that rehabilitation training of community-dwelling stroke survivors could focus on walking endurance, balance performance and dorsiflexor muscle strengthening if the aim is to augment the level of community integration.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

Kwong

Chung

et al. 2017

PLoS ONE

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“…As the results of recent studies, we indicated that some neuropsychological factors, such as depression or cognition status, might be the reasons for the decrease in the PA level (11,14,33). Cognitive impairment appears in approximately two-thirds of stroke patients in an acute setting (34).…”

Section: Discussionmentioning

confidence: 99%

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Hüseyinsinoğlu

Aslan

Tarakçı

et al. 2017

Arch Neuropsychiatr

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Introduction: Physical inactivity is an important risk factor for stroke and stroke recurrence. There is insufficient knowledge about the physical activity (PA) level in stroke patients who are ambulatory in the subacute phase. Our aim was to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate neuropsychological factors that could affect the PA level in the same stroke group.Methods: Eighty-five subacute stroke patients and 58 healthy subjects were included. Patients' demographic features, disease-related features, and comorbidities were recorded. The PA level was assessed by the International Physical Activity Questionnaire-Short Version and a pedometer (OMRON Walking style II). The Apathy Rating Scale was applied to determine the apathy level. Depression level was investigated by the Geriatric Depression Scale. The standardized Mini-mental State Examination was performed to assess the cognitive status.Results: The PA level was significantly higher in the healthy group than in the stroke group (p<0.001).Step count and walking distance were significantly higher in healthy group (p=0.001 and p=0.04, respectively). The PA level of men was significantly higher than that of women (p=0.03). Participants who were classified as level 4 had a lower PA level than those who were classified as level 5 according to the Functional Ambulation Category. There was no relationship between the PA level and the apathy, cognitive, and depression levels in the stroke patients (p>0.05). Conclusion:Subacute stroke patients have a lower PA level than healthy subjects. This is not related to neuropsychological factors. The reasons for minor deficits related to ambulation should be researched further while developing strategies for increasing the PA level of subacute stroke patients.Keywords: Stroke, apathy, depression, cognition, physical activity ABSTRACT 155level cannot be explained only by loss of motor function, psychological and cognitive factors have been proposed to analyze (13,14). In light of these findings, we aimed to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate the demographic features and disease-related and neuropsychological factors that could affect the PA level in the same stroke group. We hypothesized that the PA level of ambulatory subacute stroke patients would be less than that of healthy subjects. We further hypothesized that the PA level would be affected by neuropsychological factors in the same population.

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“…This result is in accord with previous findings that fear of falling leads to unnecessary avoidance of activities and social participation among elderly adults 34,35) and among those with stroke. [35][36][37][38][39] Tsai et al 40) reported fear of falling in almost 70% of community-dwelling stroke survivors, who also had related balance deficits 41) and falls. 40,41) Therefore, to optimize community reintegration, reduction of fear of falling should be a focus in rehabilitation settings.…”

Section: Discussionmentioning

confidence: 99%

Life-Space Mobility and Relevant Factors in Community-dwelling Individuals with Stroke in Japan: A Cross-sectional Study

Tashiro

Isho

Takeda

et al. 2019

PRM

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Objective: Individuals with stroke frequently experience mobility deficits and limited community reintegration. This study aimed to investigate life-space mobility and relevant factors in community-living individuals with stroke. Methods: This was a cross-sectional study of 46 community-dwelling individuals with chronic stroke in Japan (mean age 72.7 ± 7.4 years; mean time post-stroke 63.6 ± 43.3 months; 26 men/20 women). We measured life-space mobility using a Japanese translation of the Life-Space Assessment. The following factors that might affect life-space mobility were assessed: the ability to perform activities of daily living, physical performance, fear of falling, and cognitive function. Results: A total of 41 participants (89.1%) had restricted life-space mobility (Life-Space Assessment score <60 points). A multiple linear regression analysis showed that limitations in activities of daily living, walking speed, and Falls Efficacy Scale-International scores were independently related to Life-Space Assessment scores. This model explained 51.3% of the variance in Life-Space Assessment scores. Conclusions: Most individuals with stroke had restricted life-space mobility. Life-space mobility was associated with the ability to perform activities of daily living, walking speed, and fear of falling. These findings could contribute to the development of rehabilitation interventions for regaining life-space mobility in individuals with stroke.

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Fear Avoidance Behavior, Not Walking Endurance, Predicts the Community Reintegration of Community-Dwelling Stroke Survivors

Cited by 23 publications

References 41 publications

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Life-Space Mobility and Relevant Factors in Community-dwelling Individuals with Stroke in Japan: A Cross-sectional Study

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