WALKING SPEED BEST EXPLAINS WALKING CONFIDENCE AFTER STROKE: A CROSS-SECTIONAL STUDY

Introduction: Perception of self-efficacy influences behavioral choice and activities, including avoiding activities that individuals believe exceed their capabilities. The Modified Gait Efficacy Scale (mGES) was specifically developed to measure walking confidence of individuals moving under challenging circumstances. Objective: To explore the relationship between motor impairments and limitations (ie., lower limb strength and motor coordination, balance, walking speed, walking capacity, and perceived locomotion ability), and walking confidence in people with chronic stroke. Methods: This is a cross-sectional study, with individuals recruited from the general community. The MGES-Brazil was used to measure walking confidence and reported in scores ranging from 10 to 100. The independent measures were: hip extensors, knee extensors, and plantar flexors muscle strength, measured by the dynamometer; lower limb motor coordination, measured by the Lower Extremity Motor Coordination Test (LEMOCOT); balance, measured by the Four Square Step Test (FSST); walking speed, measured by the Ten-meter walk test (10MWT); walking capacity, measured by the Six-minute walk test (6MWT); and perceived locomotion ability, measured by the ABILOCO. Pearson correlation coefficients was used to explore the relationships between the walking measures and social participation. Step-wise multiple linear regression analysis was used to identify which walking measures would explain participation after stroke. Results: 90 individuals (35 men), with a mean age of 68 (SD 13) years, were eligible and agreed to participate. Significant correlations were found between walking confidence and hip extensor muscle strength (r=0.27; p<0.05), knee extensors muscle strength (r=0.29; p<0.01), FSST (r=-0.39; p<0.001), 10MWT (r=0.55; p<0.001), 6MWT (r=0.51; p<0.001), and ABILOCO (r=0.52; p<0.001). Regarding the regression analyses, walking speed, perceived locomotion ability, walking capacity, and hip extensor muscle strength were kept in the model. Walking speed alone explained 31% (F=39.1; p<0.001) of the variance in walking confidence. When the remaining variables were included in the model, the explained variance increased to 42% (F=21.3; p<0.001). Conclusion: The results of the present study revealed that walking speed, perceived locomotion ability, walking capacity and hip extensor muscle strength are most correlated with walking confidence, explaining 42% of the variance in the model.