Self-efficacy and Reach Performance in Individuals With Mild Motor Impairment Due to Stroke - PubMed (original) (raw)
Self-efficacy and Reach Performance in Individuals With Mild Motor Impairment Due to Stroke
Jill Campbell Stewart et al. Neurorehabil Neural Repair. 2019 Apr.
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.
Keywords: arm; confidence; kinematics; self-efficacy; stroke.
Conflict of interest statement
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Figures
Figure 1.
Schematic of reach paradigm. Six targets were presented in 2 directions (+45°,−45°) and 3 distances (8, 16, 24 cm) in an immersive virtual environment. The start switch (open square) was aligned with the sternum.
Figure 2.
Mean self-efficacy by group and arm. Each bar represents group mean with standard error bar for accuracy self-efficacy and speed self-efficacy. *p<0.05 for differences between accuracy and speed self-efficacy; **p<0.05 for differences between arms.
Figure 3.
Relationship between self-efficacy and reach performance. The relationship between endpoint error to contralateral targets and accuracy self-efficacy shown for the less affected (A) and more affected (B) arms. The relationship between movement time to ipsilateral targets and speed self-efficacy shown for the less affected (C) and more affected (D) arms. *p<0.0167 for correlation. Note that the r value in C was determined using the log of movement time; raw data presented here for ease of interpretation.
References
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