Objective

To determine whether self-efficacy (SE) mediates or moderates the relationship between motor ability at pretest and functional use of the affected arm at posttest in task-related training for stroke.

Design

Retrospective, observational cohort study.

Setting

Outpatient rehabilitation settings.

Participants

Eighty patients with chronic stroke (N=80).

Interventions

The training was delivered to the participants for 60-90 min/session, 3-5 sessions/wk for 4-6 weeks. The training involved specific robot-assisted, mirror, or combined therapy, followed by functional task practice for approximately 30 minutes in each session.

Main Outcome Measures

The outcome measure was the perceived amount of functional arm use and quality of movement evaluated by the Motor Activity Log (MAL) at posttest. The predictor was scores on the Fugl-Meyer Assessment (FMA)–Upper Extremity subscale at pretest. The tested mediator and moderator were scores on the Stroke Self-Efficacy Questionnaire (SSEQ) at pretest and posttest.

Results

The SSEQ scores at pretest and posttest moderated the predictive relationship of pretest FMA to posttest MAL. The interaction between pretest FMA and SSEQ accounted for an additional 3.14%-5.37% of the variance in the posttest MAL. The predictive relationship between FMA and MAL was its greatest when the SSEQ was high, with a less amplified positive relationship at low levels of SSEQ.

Conclusions

The results suggest the evaluation of SE at pretest for a better prediction of an individual patient's functional arm use after an intervention and recommend aiming at SE during training to make the most of motor ability transferred to functional use. Future research may compare the effectiveness of task-related training with and without SE building to verify the findings of this study.

中文翻译：

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中风任务相关训练后，自我效能在运动能力与功能表现预测关系中的作用：纵向数据的二次分析

客观的

确定自我效能感 (SE) 是否介导或调节了中风任务相关训练中前测时的运动能力与后测时受影响手臂的功能使用之间的关系。

设计

回顾性、观察性队列研究。

环境

门诊康复设置。

参与者

80 名慢性中风患者 (N=80)。

干预

培训为参与者提供 60-90 分钟/节，3-5 节/周，持续 4-6 周。培训包括特定的机器人辅助、镜像或组合疗法，然后是每节约 30 分钟的功能性任务练习。

主要观察指标

结果测量是在后测中通过运动活动日志 (MAL) 评估的功能性手臂使用量和运动质量的感知量。预测因子是在预测试时 Fugl-Meyer 评估 (FMA)-上肢分量表的分数。被测试的中介和主持人在前测和后测中风自我效能问卷（SSEQ）中得分。

结果

前测和后测的 SSEQ 分数调节了前测 FMA 与后测 MAL 的预测关系。前测 FMA 和 SSEQ 之间的相互作用占后测 MAL 方差的额外 3.14%-5.37%。当 SSEQ 较高时，FMA 和 MAL 之间的预测关系最大，而在 SSEQ 水平较低时，正相关关系放大较小。

结论

结果表明，在预测试时评估 SE 可以更好地预测干预后个体患者的功能性手臂使用，并建议在训练期间针对 SE 以充分利用转移到功能性使用的运动能力。未来的研究可能会比较有和没有 SE 建设的任务相关培训的有效性，以验证本研究的结果。