Research Article| Volume 26, ISSUE 2, P237-245, February 2017

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Balance Confidence Is Related to Features of Balance and Gait in Individuals with Chronic Stroke

  • Alison Schinkel-Ivy
    Address correspondence to Alison Schinkel-Ivy, PhD, Nipissing University, Room 201-C Robert J. Surtees Athletic Centre, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada.
    Toronto Rehabilitation Institute–University Health Network, Toronto, Ontario, Canada
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  • Jennifer S. Wong
    Toronto Rehabilitation Institute–University Health Network, Toronto, Ontario, Canada
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  • Avril Mansfield
    Toronto Rehabilitation Institute–University Health Network, Toronto, Ontario, Canada

    Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada

    Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
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      Reduced balance confidence is associated with impairments in features of balance and gait in individuals with subacute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify the relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke.


      Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months postdischarge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable, and quiet standing, walking, and reactive stepping outcome measures as the dependent variables.


      Walking velocity was positively correlated with balance confidence, whereas mediolateral center of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence.


      This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs.

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