The Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B): a structural validity analysis.

BACKGROUND: Self-efficacy has been shown to play an important role in rehabilitation outcomes of stroke patients. The Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) is designed to assess self-efficacy of functional performance after stroke. OBJECTIVE: This research sought to address the structural validity of the SSEQ-B using exploratory and confirmatory factorial analyses. METHODS: This is a cross-sectional study. We performed a reliability assessment and structural validation of the SSEQ-B in 115 Brazilian stroke survivors living in Rio Grande do Sul or São Paulo. Results: Sample mean age was 62.7 ± 14.2 years. Internal consistency presents a Cronbach's Alpha (αC) of 0.829. Exploratory factorial analysis using the scree plot method revealed a bifactorial structure, consisting of activity and self-management domains. While confirmatory factorial analysis suggested a trifactorial structure, the loading ranges between factors 1 and 3 were very similar, suggesting they could be collapsed - resulting in the same factors found in the scree plot analysis. Both structures with subscales showed good construct validity. CONCLUSION: SSEQ-B is a valid and reliable measure of stroke self-efficacy. The preferred structure of the SSEQ-B is bifactorial and includes the domains activity and self-management.

Translation, Cross-Cultural Adaptation, and Validation of the Physical Activity Scale for Individuals With Physical Disabilities for Brazilian Individuals With Parkinson's Disease.

The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) is not available to Portuguese-Brazil. This study translates, cross-culturally adapts, and validates the PASIPD for Brazilian individuals with Parkinson's disease. The translation process followed guidelines: initial translation, synthesis, back translation, expert committee, and pretest. The validation and reliability processes were conducted with 40 individuals (15 men and 25 women) with Parkinson's disease. Concurrent validity was evaluated between PASIPD to Brazilian Portuguese, International Physical Activity Questionnaire, and Human Activity Profile. PASIPD to Brazilian Portuguese was found to be moderately correlated with International Physical Activity Questionnaire (r = .474, p < .05); however, there was no correlation with Human Activity Profile (r = .271, p < .05). We used the intrarater reliability with intraclass correlation coefficient and test-retest. Intrarater reliability was high (intraclass correlation coefficient = .80). Internal consistency was considered adequate by Cronbach's alpha (α = .70). PASIPD to Brazilian Portuguese is a valid and reliable instrument for evaluating physical activity levels in Brazilian individuals with Parkinson's disease.

The concurrent validity of the Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) in brazilian stroke survivors / Validade concorrente do Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) em brasileiros acometidos pelo acidente vascular cerebral

The Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) is designed to assess the self-efficacy of functional performance after stroke. Objective: To evaluate the concurrent validity of the SSEQ-B in Brazilian stroke survivors in relation to gold-standard measures of instrumental and basic daily living activities as well as quality of life after stroke. Methods: The concurrent validity of the SSEQ-B was tested using the Frenchay Activity Index (FAI), Barthel Index (BI) and Stroke Specific Quality of Life Scale (SS-QOL). Descriptive statistics, the Spearman's coefficient index, Intraclass correlation coefficient (ICC), Cronbach alpha and achieved post-hoc power (1-ß) analyses were conducted. Results: Seventy-five stroke survivors aged 66.64 ± 12.97 years were included in this study. Total scores from the SSEQ-B were strongly correlated with the FAI (ICC= 0.8 / r= 0.72 / 1-ß= 1.0) and BI (ICC= 0.68 / r= 0.68 / 1-ß= 0.99), but weakly correlated with SS-QOL (ICC= 0.46 / r= 0.65 / 1-ß= 0.94), which suggests stroke self-efficacy is more closely associated with instrumental and daily living activities than the quality of life. Conclusion: The SSEQ-B exhibits good concurrent validity with instrumental and daily living activities and could be useful when assessing stroke self-efficacy in Brazilians.

O Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B) foi desenvolvido para avaliar a autoeficácia no desempenho funcional depois do Acidente Vascular Cerebral (AVC). Objetivo: avaliar a validação concorrente do SSEQ-B em sobreviventes brasileiros de AVC em relação a avaliações padrão áureo de atividades de vida diárias e instrumentais assim como a qualidade de vida pós-AVC. Métodos: A validação concorrente do SSEQ-B foi avaliada utilizando o Índice de Atividade Frenchay (FAI), o Índice de Barthel (BI) e a Qualidade de Vida pós-AVC (SS-QOL). As análises de estatística descritiva, índice de coeficiente Spearman's, coeficiente de correlação intraclasse (ICC), alpha de Cronbach e potência post-hoc alcançada foram conduzidas. Resultados: Setenta e cinco sobreviventes de AVC com idade de 66.64 ± 12.97 anos foram incluídos neste estudo. A pontuação total do SSEQ-B foi correlacionada significativamente com o FAI (ICC= 0.8 / r= 0.72 / 1-ß= 1.0), BI (ICC= 0.68 / r= 0.68 / 1-ß= 0.99) e SS-QOL (ICC= 0.46 / r= 0.65 / 1-ß= 0.94), o que sugere que a autoeficácia de sobreviventes de AVC está associada com as atividades de vida diárias e instrumentais. Porém, há fraca correlação com a qualidade de vida desta amostra. Conclusão: O SSEQ-B exibe uma boa validação concorrente com as atividades de vida diárias e instrumentais e parece ser útil na avalição da autoeficácia em sobreviventes de AVC residentes no Brasil.

Adherence rate, barriers to attend, safety and overall experience of a physical exercise program via telemonitoring during COVID-19 pandemic for individuals with Parkinson's disease: A feasibility study.

BACKGROUND: Telemonitoring can maintain daily exercise routine during the COVID-19 pandemic of individuals with Parkinson's disease (PD). However, there are barriers to adherence and attendance with remote physical rehabilitation. The main objective of this study was to evaluate adherence rate, barriers to attendance, and safety of a telemonitoring program for individuals with PD; and secondarily to evaluate the individual and their family members perceived overall experience when performing the telemonitoring physical exercise program. METHODS: This was a phase 1 of a clinical trial, engaging 19 individuals with idiopathic PD of an in-person community rehabilitation program. For 24 weeks an asynchronous telemonitoring physical exercise program delivered two sessions per week by video including warm-up, balance, aerobic and resistance exercises, and cool-down. During the remote program were verified: adherence rate at entrance, attendance rate, barriers to attend, safety, and overall experience of the program. RESULTS AND CONCLUSION: Only one participant did not perform any session and 18 participants completed between 2 and 34 sessions. Participants with a caregiver showed higher attendance rates. The most frequently cited barriers to attend the program were: pain; lack of motor skills; and reduced physical fitness. In relation to safety of the program, the most frequently reported was fear of falling. Although participants reported the telemonitoring program induced health benefits and they had positive experiences for themselves and for their families, most of participants prefer an in-person program. In this sense, the asynchronous telemonitoring physical exercise program was safe, showed moderate adherence, with attendance rate depending on the presence of a companion.

Adherence Rate, Barriers to Attend, Safety, and Overall Experience of a Remote Physical Exercise Program During the COVID-19 Pandemic for Individuals After Stroke.

Introduction: The actions taken by the government to deal with the consequences of the coronavirus diseases 2019 (COVID-19) pandemic caused different levels of restriction on the mobility of the population. The need to continue offering physical exercise to individuals after stroke became an emergency. However, these individuals may have barriers to adhere to the programs delivered remotely. There is a lack of evidence related to adherence, attendance, safety, and satisfaction of remote exercise programs for this population. Objective: The aim was to evaluate adherence and barriers to attend a remote physical exercise program for individuals after stroke. We aimed (a) to identify adherence and attendance rate of the remote physical exercise program (i.e., number of participants engaged, number of sessions attended, and exercise time in remote program); (b) to identify the safety of a remote physical exercise program (i.e., falls, pain, or dizziness when performing the exercises, fear, or insecurity); and (c) to identify the overall experience to participate in a remote program. Materials and methods: This is a longitudinal study, including 36 stroke survivors who already attended a face-to-face physical exercise program prior to the COVID-19 pandemic. The remote physical exercise program included sessions for 2 days/week for a duration of 22 weeks, with a total of 44 sessions, which were delivered asynchrony via recorded video sessions. As outcome measures, we performed two questionnaires (via weekly telephone calls) to identify attendance, barriers, safety, and overall experience related to the program. Results: The adherence rate was 86 (9%). The attendance rate was 19, with a total of 8 sessions (108.3 min/week). The main barriers for lower attendance rate were as follows: lack of motor skills and physical fitness to workout in 80 reports (20.6%), followed by no exercise companion in 44 reports (11.3%). The remote physical program has been shown to be safe, and the overall experience was positive from the perspectives of the participants and the family members. Conclusion: Although the adherence rate was high, the attendance rate was low on the remote physical exercise program. The main barriers to attending the program remotely reflect the need of tailoring individually an asynchrony mode of delivering the sessions to individuals after stroke. Our results also indicate how the COVID-19 impacted the health conditions of stroke survivors. The program was safe, and the overall experience indicated a change in the mental, physical, and social health of individuals after stroke and their family members.

Dupla deficiência motora em um centro de reabilitação: hemiparesia após acidente vascular cerebral e amputação de membro inferior - Quem são eles? / Dual motor disability in an outpatient rehabilitation center: hemiparesis after stroke and lower limb amputation patients - Who are they?

Objetivo: Estimar a prevalência da dupla deficiência motora e identificar as características social, demográficas, clinicas e relacionadas á reabilitação desses indivíduos. Métodos: Estudo descritivo retrospectivo realizado em um centro de reabilitação com indivíduos com dupla deficiência motora decorrente de amputação de membro inferior associada à hemiparesia após acidente vascular cerebral (AVC). Características sociodemografica, clinica e relacionada a reabilitação foram coletadas através de consulta a prontuários. Resultados: A prevalência da dupla deficiência motora foi de 5,4%. Dos 76 indivíduos avaliados, 69,7% eram do sexo masculino, com média de idade de 65,6 (±9,3). A hipertensão arterial sistema estava presente em 96,1% dos indivíduos e 25% eram tabagistas. Mais que 73% dos pacientes tiveram o AVC prévio à amputação. O tempo entre as lesões foi, em mediana, de 23 meses, as sequelas foram ipsilaterais em 51,3% dos pacientes. Desses, 54 pacientes (71%) foram encaminhados para as terapias físicas. O tempo entre a dupla deficiência e o início da terapia foi de 28 meses, com tempo de reabilitação total de 14,3 meses. Ao fim do processo de reabilitação 36% alcançaram suas metas, mas 30% teve alta devido a falta de adesão ao tratamento. Conclusão: A prevalência da dupla deficiência motora devido a hemiparesia após AVC e amputação de membro inferior foi 5,4%, e a população estudada apresentou características singulares relacionada ao processo de reabilitação, como um longo tempo entre a ocorrência da dupla deficiência e o inicio da reabilitação, e um longe tempo na reabilitação.

Objectives: To estimate the prevalence of dual motor disability and to identify social, demographic, clinical and rehabilitation-related characteristics. Methods: Retrospective descriptive study in an outpatient rehabilitation center with individuals with dual motor disability from major lower limb amputation associated to post-stroke hemiparesis. Social demographic, clinical and rehabilitation characteristics data were collected from medical record. Results: The prevalence of dual motor disability was 5.4%. Seventy-six subjects were evaluated, 69.7% were male, with a mean age of 65.6 ± 9.3 years. Hypertension was present in 96.1% of subjects, and 25% were smokers. Over 73% of patients had had the stroke prior to amputation. Time elapsed between lesions had a median of 23 months, and sequelae were ipsilateral in 51.3% of patients. Of these, 54 patients (71%) were referred to physical therapy. The time interval between dual disability and the beginning of therapy was 28 months, with total rehabilitation time of 14.3 months. At rehabilitation completion, 36% achieved their goals but 30% were discharges consequent to lack of compliance. Conclusion: The prevalence of dual motor disability due to hemiparesis secondary to stroke and lower limb amputation in a rehabilitation center was 5.4%. Our population showed singular characteristics related to the rehabilitation process, such as a long time between the occurrence of dual disability and the beginning of rehabilitation, and long rehabilitation period.

Translation and validation of the stroke self-efficacy questionnaire to a Portuguese version in stroke survivors.

BACKGROUND: Stroke Self-efficacy Questionnaire (SSEQ) is not available to Portuguese-Brazil.Objective: To translate, perform cross-cultural adaptation, and validate the Stroke Self-efficacy Questionnaire (SSEQ) to Portuguese-Brazil (SSEQ-B).Methods: It is a cross sectional study: 1) translation and cross-cultural adaptation of SSEQ - a five stage process, 2) validation and reliability study with 40 chronic stroke survivors. The outcomes were: Content Validity Index (CVI), Face validity index, Reliability, Internal consistency, Stability, Ceiling and floor effects Concurrent validity, Measurement error using Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC). Results: There was high agreement for the English to Portuguese-Brazil translation. Adjustments were made to improve semantic equivalence. Intra-examiner reliability was high (ICC 0.86) as was inter-examiner reliability (ICC 0.91). Internal consistency was acceptable for the total score, the activity subscale and self-management domain, Cronbach alphas are 0.82, 0.77, 0.68, respectively. The stability of the SSEQ-B was high and good (r = 0.77 p < .001). Ceiling effects were evident in 7.5% of the sample. For concurrent validity, there was an inverse relationship between BDI and SSEQ-B (r = -0.43 p = .006), and a positive relationship between FIM (r = 0.52 p < .001), SIS (r = 0.64 p < .001) and SSEQ-B. SEM was 1.58 points of the SSEQ-B and the MDC was 4.38 points of SSEQ-B. Conclusion: SSEQ-B is a valid, reliable, and stable patient-reported outcome. It has concurrent validity with self-reported measures of depression, functional independence and a multi-dimensional measure of health status in chronic stroke survivors in Brazil.