Leveraging Factors of Self-Efficacy and Motivation to Optimize Stroke Recovery

Abstract

The International Classification of Functioning, Disability and Health framework recognizes that an individual's functioning post-stroke reflects an interaction between their health condition and contextual factors encompassing personal and environmental factors. Personal factors significantly impact rehabilitation outcomes as they determine how an individual evaluates their situation and copes with their condition in daily life. A key personal factor is self-efficacy—an individual's belief in their capacity to achieve certain outcomes. Self-efficacy influences an individual's motivational state to execute behaviors necessary for achieving desired rehabilitation outcomes. Stroke rehabilitation practice and research now acknowledge self-efficacy and motivation as critical elements in post-stroke recovery, and increasing evidence highlights their contributions to motor (re)learning. Given the informative value of neuroimaging-based biomarkers in stroke, elucidating the neurological underpinnings of self-efficacy and motivation may optimize post-stroke recovery. In this review, we examine the role of self-efficacy and motivation in stroke rehabilitation and recovery, identify potential neural substrates underlying these factors from current neuroimaging literature, and discuss how leveraging these factors and their associated neural substrates has the potential to advance the field of stroke rehabilitation.

Health-Related Quality of Life and Functional Status Following Intensive Neurorehabilitation in a Patient after Severe Head Injury with Spinal Epidural Hematoma: A Case Report

“…It is well documented that it has a crucial influence on the treatment progress. The individual sense of self-efficacy affects the motivation to perform the appropriate behaviors necessary to achieve the desired rehabilitation outcomes [36,37]. Adequate levels of motivation significantly impact enhancing psychological functioning, increasing self-confidence, and improving the abilities needed to cope with the consequences of a neurological deficit, which in turn promotes a good prognosis in the long term [38,39].…”

Different Patterns of Neural Activity Characterize Motor Skill Performance During Acquisition and Retention

“…Moreover, aspects of intrinsic motivation including effort/importance attributed to the task can also be influenced by the motivational statements as supported by the trend for higher effort/importance ratings reported by the motivation plus feedback group ( Supplementary Figure 6 ). This effect may be critical for motor skills that require dynamic and delicate motor control such as playing a musical instrument, operating a medical tool, or recovering compromised motor control through neurorehabilitation, where learning can be improved through incorporation of motivational statements during training ( Gangwani et al, 2022 ).…”

Traditional umbrella painting activity improved upper extremity function and decreased depression in stroke survivors in Northern Thailand

“…Furthermore, several studies 15,22,[37][38][39][40][41] demonstrated that participating in art activities helped with relaxation, self-esteem, inspiration, and distraction in a stressful rehabilitation environment, which could lead to less depression in stroke patients. Gangwani et al 42 identified factors affecting post-stroke recovery that self-esteem, and motivation could promote good rehabilitation outcomes. Alwledat, et al 38 studied the effects of two sessions per week, 1.5 hours per session, for two weeks of creative art therapy on depression, anxiety, and stress on 85 stroke patients, which demonstrated that art activities could significantly reduce depression, anxiety, and stress in these participants.…”