A domain-specific approach to characterizing falls efficacy post-stroke.

Area of Science:

• Neuroscience
• Rehabilitation Science
• Psychometrics

Background:

• Falls efficacy is crucial for mobility and independence in individuals post-stroke.
• The Activities-Specific Balance Confidence (ABC) scale is widely used to assess this construct.
• Understanding the factor structure of the ABC scale in stroke populations is essential for targeted interventions.

Purpose of the Study:

• To determine if the Activities-Specific Balance Confidence (ABC) scale measures distinct factors in individuals with chronic stroke.
• To investigate the underlying structure of falls efficacy as assessed by the ABC scale.

Main Methods:

• Cross-sectional analysis of pre-existing data from 248 community-dwelling adults with a history of stroke.
• Confirmatory factor analysis was employed to test a hypothesized three-factor structure (anticipatory, walking, and reactive balance).
• Goodness-of-Fit indices (RMSEA, CFI, TLI) were used to evaluate the model.

Main Results:

• The confirmatory factor analysis supported the hypothesized three-factor structure of the ABC scale.
• Items related to anticipatory control, walking balance, and reactive balance loaded significantly as predicted.
• One item (reaching while on a stool) showed potential multidimensionality, reflecting both anticipatory and reactive balance confidence.

Conclusions:

• The findings suggest that the ABC scale effectively measures three distinct subfactors of falls efficacy in chronic stroke survivors.
• These subfactors align with anticipatory control, walking balance, and reactive balance domains.
• This nuanced understanding can inform the development of more specific rehabilitation strategies to improve balance confidence and reduce fall risk.