PTOTCohortJournal of neurologic physical therapy : JNPT2019

Belief, Confidence, and Motivation to Use the Paretic Upper Limb in Daily Life Over the First 24 Weeks After Stroke.

Kimberly J Waddell, Rachel G Tabak, Michael J Strube and 2 others

PMID 31436612

WHAT IT FOUND

Stroke survivors remained highly confident and motivated to use their weak arm over the first six months, regardless of physical recovery or mood.

This suggests therapists can assume patients are ready to engage and should focus on removing practical barriers rather than boosting morale.

Key findings

01Participants consistently reported high belief, confidence, and motivation to use their paretic arm throughout the 24-week study.

02Psychosocial factors were not associated with upper limb capacity, depression, or cognitive function.

03Self-perceived barriers shifted over time, with limited movement being most common early on and difficulty performing tasks correctly being most common later.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The sample size was small (30 participants), limiting generalizability. Most participants improved physically, which may have sustained their high confidence. The study did not control for the dose or type of rehabilitation received. Dropouts occurred, and it is unknown if those who left had lower motivation. The survey did not distinguish between intrinsic and extrinsic motivation.

Declared interests

The authors declare no conflicts of interest.

The easy way to misread this

Do not interpret the lack of correlation with depression or physical capacity as evidence that these factors are irrelevant to recovery. The high baseline levels of motivation may have created a ceiling effect, masking potential relationships in a more diverse population.

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