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Measuring Exercise Self-Efficacy After Stroke: Validity and Reliability of Current Measures
Karl Espernberger1, Natalie A Fini, Allison Ezzat
1La Trobe University, School of Allied Health, Human Services and Sport, Melbourne, Victoria, Australia (K.E., A.E., and C.L.P.); Physiotherapy Department, Donvale Rehabilitation Hospital, Donvale, Victoria, Australia (K.E.); Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia (N.A.F.); Department of Physical Therapy, University of British Columbia, Vancouver, Canada (A.E.); and Allied Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia (C.L.P.).
Background And Purpose:
Many physically capable stroke survivors are insufficiently active, with low self-efficacy considered an important contributor. However, validity and reliability of self-efficacy measures in stroke survivors have not been established. This research aims to evaluate the test-retest reliability and construct validity of 3 self-efficacy measures: Self-Efficacy for Exercise Scale (SEE), Spinal Cord Injury Exercise Self-Efficacy Scale (SCI-ESES), and Participation Strategies Self-Efficacy Scale (PS-SES).
Methods:
A repeated measures study with community-dwelling, independently mobile adult stroke survivors (n = 51, mean age 74 years, 45% female, median 22 months poststroke) was completed. Test-retest reliability was assessed using intraclass correlation coefficients and Bland-Altman analyses. Construct validity was assessed using 8 pre-determined hypotheses concerning physical activity level (subjective and objective), comorbidities, work and volunteering, and measures of function.
Results:
Retest reliability was established for the SEE (intraclass correlation coefficient, ICC = 0.77) and PS-SES (ICC = 0.78) but not for the SCI-ESES (ICC = 0.68). Bland-Altman analysis showed participants consistently scored higher on the second test for all measures. The SEE achieved construct validity by meeting 75% of hypotheses, whereas the PS-SES and SCI-ESES did not. Self-efficacy was positively related to steps/day, functional capacity, self-reported activity levels, and work or volunteering participation.
Discussion And Conclusions:
The SEE was found to be the most appropriate tool to measure exercise self-efficacy in independently mobile chronic stroke survivors in terms of retest reliability and validity.
Trial Registration:
N/A.
Video Abstract Available:
for more insights from the authors (see the Video, Supplemental Digital Content 1 "Espernberger-JNPT-Video-Abstract," available at: http://links.lww.com/JNPT/A489 ).
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