Measuring Exercise Self-Efficacy After Stroke: Validity and Reliability of Current Measures.

Abstract

Many physically capable stroke survivors are insufficiently active, with low self-efficacy considered an important contributor. However, validity and reliability of self-efficacy measures in stroke survivors have not been established. This research aims to evaluate the test-retest reliability and construct validity of 3 self-efficacy measures: Self-Efficacy for Exercise Scale (SEE), Spinal Cord Injury Exercise Self-Efficacy Scale (SCI-ESES), and Participation Strategies Self-Efficacy Scale (PS-SES). A repeated measures study with community-dwelling, independently mobile adult stroke survivors (n=51, mean age 74years, 45% female, median 22months poststroke) was completed. Test-retest reliability was assessed using intraclass correlation coefficients and Bland-Altman analyses. Construct validity was assessed using 8 pre-determined hypotheses concerning physical activity level (subjective and objective), comorbidities, work and volunteering, and measures of function. Retest reliability was established for the SEE (intraclass correlation coefficient, ICC=0.77) and PS-SES (ICC=0.78) but not for the SCI-ESES (ICC=0.68). Bland-Altman analysis showed participants consistently scored higher on the second test for all measures. The SEE achieved construct validity by meeting 75% of hypotheses, whereas the PS-SES and SCI-ESES did not. Self-efficacy was positively related to steps/day, functional capacity, self-reported activity levels, and work or volunteering participation. The SEE was found to be the most appropriate tool to measure exercise self-efficacy in independently mobile chronic stroke survivors in terms of retest reliability and validity. N/A. for more insights from the authors (see the Video, Supplemental Digital Content 1 "Espernberger-JNPT-Video-Abstract," available at: http://links.lww.com/JNPT/A489).