Balance confidence, balance, and gait capacity in chronic stroke: baseline and change correlations

Balance confidence is associated with selected balance and gait measures after stroke, but whether changes in confidence track concurrent changes in objective capacity is unclear.

This prespecified secondary analysis included 168 independently ambulant adults with chronic stroke from a single-center randomized trial. Balance confidence was assessed with the Activities-specific Balance Confidence scale. Objective outcomes included center-of-pressure sway velocity, limits of stability, Berg Balance Scale, Timed Up and Go, 10-Meter Walk Test time, and instrumented spatiotemporal gait measures. Pearson correlations with 95% confidence intervals and false discovery rate correction were used; Spearman, intervention-arm-centered change, and height-normalized spatial gait analyses assessed robustness.

At baseline, associations between ABC scores and objective balance and gait measures were small, and none were statistically significant after false discovery rate correction. Change-to-change associations were also small, and none remained significant after multiplicity adjustment. Intervention-arm centering eliminated the unadjusted treadmill-speed association observed in the pooled change analysis, whereas the small association with center-of-pressure sway velocity remained similar but did not survive false discovery rate correction. Height normalization of spatial gait measures did not materially alter the findings.

Balance confidence was weakly coupled with measured balance and gait capacity at baseline and over time. The findings do not establish independence but support assessing perceived confidence and objective capacity as complementary outcomes after stroke.