Leveraging Factors of Self-Efficacy and Motivation to Optimize Stroke Recovery.

Rachana Gangwani,Amy Collins,Amelia Cain,Jessica M Cassidy

doi:10.3389/fneur.2022.823202

Rachana Gangwani, Amy Collins + Show 2 more

Open Access

https://doi.org/10.3389/fneur.2022.823202

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Abstract

The International Classification of Functioning, Disability and Health framework recognizes that an individual's functioning post-stroke reflects an interaction between their health condition and contextual factors encompassing personal and environmental factors. Personal factors significantly impact rehabilitation outcomes as they determine how an individual evaluates their situation and copes with their condition in daily life. A key personal factor is self-efficacy—an individual's belief in their capacity to achieve certain outcomes. Self-efficacy influences an individual's motivational state to execute behaviors necessary for achieving desired rehabilitation outcomes. Stroke rehabilitation practice and research now acknowledge self-efficacy and motivation as critical elements in post-stroke recovery, and increasing evidence highlights their contributions to motor (re)learning. Given the informative value of neuroimaging-based biomarkers in stroke, elucidating the neurological underpinnings of self-efficacy and motivation may optimize post-stroke recovery. In this review, we examine the role of self-efficacy and motivation in stroke rehabilitation and recovery, identify potential neural substrates underlying these factors from current neuroimaging literature, and discuss how leveraging these factors and their associated neural substrates has the potential to advance the field of stroke rehabilitation.

Highlights

Stroke is a heterogeneous condition resulting in profound and wide-ranging effects on physical, psychological, and social aspects of an individual’s life [1, 2]
We identify potential neural substrates underlying motivation, self-efficacy, and constructs of selfefficacy such as self-agency from current neuroimaging literature, and discuss how leveraging these factors and their associated neural substrates has the potential to advance the field of stroke rehabilitation
This review examines the roles of selfefficacy and motivation in stroke rehabilitation and recovery while distinguishing itself from other reviews by bridging topics of self-efficacy and motivation with neuroimaging and biomarker development

Summary

INTRODUCTION

Stroke is a heterogeneous condition resulting in profound and wide-ranging effects on physical, psychological, and social aspects of an individual’s life [1, 2]. Related to selfefficacy is motivation, which refers to an individual’s will to perform a certain behavior toward achieving their goal and is one of the processes through which self-efficacy affects human functioning and impacts post-stroke rehabilitation outcomes [17]. Post-stroke self-management programs led by therapists incorporating self-efficacy and motivation factors focus on goal-setting and empowering individuals with information, support and resources to facilitate post-acute care transition and symptom management [15, 57, 58] Such self-management strategies have resulted in improved confidence in recovery, better long-term health outcomes, and a reduction in post-stroke complications [33, 59, 60] as evidenced by increased physical activity, improved self-reported mobility and fine motor-skill performance, and elevated balance confidence [61, 62]. The identification of pertinent neural correlates (i.e., relevant neural structures and connections) of self-efficacy and motivation may enhance the accuracy of existing post-stroke recovery prediction models

Findings

DISCUSSION

CONCLUSION