The effectiveness of rehabilitation interventions has traditionally been measured using tests of physical capacity. The rehabilitation process, however, comprises many ingredients that set up a cascade of effects that impact beyond simple physical capacity. In this thesis, the vehicle of a clinical trial conducted to evaluate the efficacy of a walking intervention for persons with chronic stroke was used to illustrate the array of outcomes that are impacted upon by a rehabilitation intervention. First, the walking intervention was proven effective in enhancing two traditional capacity outcomes: functional walking capacity and walking speed. The intervention primarily benefited functional walking capacity, measured as the distance a person can walk in six minutes, indicating the task-specificity of training effects. Persons with a baseline walking deficit of moderate severity responded to the walking intervention to a greater extent than persons with mild or severe impairment. Following, the role of a less traditional construct---self-efficacy for balance activities---as an outcome of stroke rehabilitation was evaluated. Self-efficacy reflects perceived ability and it is measured not by direct testing but rather by self-report. It was hypothesized that the walking intervention would benefit balance self-efficacy in addition to functional walking capacity given that mastering a task is expected to enhance self-efficacy for that task. Thesis findings supported this hypothesis and suggested that the level of depressive symptoms may modify effects. Self-efficacy was also expected to influence physical functioning as much as physical capacity and this hypothesis was verified. Self-efficacy was also an independent predictor of perceived health status. Additional associations were observed between balance self-efficacy and age, gender, depression and functional capacity. Before recommending the evaluation of balance self-efficacy in rehabilitation
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.85645 |
| Date | January 2004 |
| Creators | Salbach, Nancy Margaret |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 002198654, proquestno: AAINR12941, Theses scanned by UMI/ProQuest. |
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