Date Presented 3/31/2017
Physical activity is important for the prevention of recurrent stroke and overall health in people with stroke. In this study, patient perceptions of self-efficacy, self-regulation, social support, and outcome expectations related to physical activity were examined.
Primary Author and Speaker: Ryan Bailey
PURPOSE AND BACKGROUND: This study sought to examine self-efficacy, self-regulation, social support, and outcome expectations related to lifestyle physical activity (PA). Physical inactivity and sedentary behavior are global public health concerns and of particular concern for people with stroke. Increasing PA reduces the risk for recurrent stroke, disability, and mortality. Interventions that enhance self-efficacy, self-regulation, social support, and outcome expectations have been effective in modifying various health behaviors across patient populations, but how these variables relate to lifestyle PA (i.e., the incorporation of light- and moderate-intensity PA in daily activities) in people with stroke has not yet been examined. This preliminary, cross-sectional study examined patient perceptions of self-efficacy, self-regulation, social support, and outcome expectations related to lifestyle PA in people with stroke.
DESIGN: Participants (N = 21) for this cross-sectional study were recruited through community-based stroke support groups and Emory University in Atlanta, GA. Inclusion criteria were age 30–80, community dwelling, ambulatory (ambulation FIM™ score ≥5), intact cognition (Short Blessed Score <8), and at least 6 mo poststroke.
METHOD: Participants completed a battery of self-report questionnaires to assess self-efficacy for engaging in PA, use of self-regulation and social support strategies for being physically active, and positive and negative outcome expectations about being physically active. Wording of validated, exercise-based questionnaires was modified to reflect lifestyle PA, and questionnaire scores were standardized across measures (max score = 100). Mean, standard deviation, and 95% confidence interval (CI) were calculated. No analytical statistics were performed due to the small sample size, but variables with overlapping CIs were considered to be similar. Demographic and personal characteristics were also recorded.
RESULTS: Participants’ mean age was 55.2 yr (SD = 11.7), median years poststroke was 2.1 (interquartile range [IQR] = 3.7), mean body mass index was 29.1 (SD = 5.2), and median Barthel Index was 100 (IQR = 2.5). Examination for overlap of confidence intervals revealed three separate groupings of variables. Self-efficacy (M = 87, SD = 10, CI [82, 92]) and positive outcome expectations (M = 90, SD = 8, CI [87, 94]) were high and had overlapping confidence intervals. Self-regulation (M = 54, SD = 19, CI [48, 65]) and social support (M = 56, SD = 18, CI [50, 67]) were moderate and had overlapping confidence intervals. Negative outcome expectations (M = 38, SD = 13, CI [32, 44]) were low.
CONCLUSION: In this sample of participants with mild stroke, self-efficacy and positive outcome expectations related to PA were high while negative outcome expectations were low, which likely serve as motivating factors for engaging in PA. These factors should be capitalized upon when encouraging people with stroke to engage in lifestyle PA. In contrast, use of self-regulation and social support strategies was moderate and could possibly be modified through behavioral training to indirectly increase poststroke PA. Future research should investigate whether interventions that increase use of self-regulation and social support strategies lead to increased poststroke PA. Additionally, validated assessments that measure self-efficacy, self-regulation, social support, and outcome expectations related to lifestyle PA in people with stroke are needed.
IMPACT STATEMENT: Patient perceptions of self-efficacy, self-regulation, social support, and outcome expectations related to physical activity vary and should be considered when promoting physical activity after stroke.
