10.4172/2165-7025.1000182

Abstract

IntroductionPhysical rehabilitation post-stroke aims to optimize balance; mobility and gait function so that people can be physically active and participate in meaningful activities [1,2]. Physical activity is important to maintaining health and reducing the risk of cardiovascular disease and recurrent stroke [3,4]. Self-report measures of physical activity, while simple and affordable, may overestimate levels determined on objective testing [5]. The use of accelerometers provides an alternative method to objectively quantify physical activity [6][7][8]. Participation encompasses physical activity as it denotes the involvement of individuals in activities, including relationships, community activities, work, recreation and leisure, that bring meaning to life [9]. Investigation of the relationship between physical rehabilitation outcomes and physical activity has been primarily restricted to motor, balance and walking capacity. For example, physical activity measured using an accelerometer has been found to correlate with scores on the Berg balance scale [10] (BBS) (r=0.54-0.58) [7,11], self-selected gait speed [12] (r=0.55-0.65) [6,7,11], and 6-minute walk test [13] (6MWT) performance (r=0.67-0.73) [6][7][8]. Examination of relationships between physical activity and motor function and broader outcomes such as social participation and health-related quality of life has been limited to one study of people with mild gait deficits post-stroke (mean self-selected gait speed 1.01 meters/second (m/s)) in which no correlations were observed [7]. In addition, although balance selfefficacy has been recognized as a predictor of self-reported physical function and perceived health status [14], its association with physical activity directly measured using accelerometry is unknown. Balance self-efficacy refers to perceptions of ability to perform everyday activities without losing balance or becoming unsteady [15]. Selfefficacy is considered a modifiable outcome [16] that could be targeted through physical rehabilitation to influence physical activity and participation. Increasing understanding of the relative influence of physical rehabilitation outcomes on physical activity and participation can help to guide treatment planning, the selection of appropriate goals during rehabilitation after stroke, and inferences about potential to function in the community. Although predictors of participation have been previously investigated [17,18], the comparative influence of physical rehabilitation outcomes on both daily physical activity and participation has received little attention. Thus, the objective of this study was to examine the extent to which daily physical activity and social participation are associated with clinical measures of motor function, balance, balance self-efficacy, functional mobility, and walking speed and distance in community-dwelling people with stroke. Based on the literature, it was hypothesized that moderatelevel (i.e., 0.50-0.69) correlations would be observed. AbstractObjective: To examine the ex...