Objective
To investigate the psychometric properties of the balance self-efficacy (BSE) scale in people with stroke.
Methods
This is a cross-sectional study held in a university-based rehabilitation center. Sixty- three people with stroke and 30 healthy older adults were included from the community dwelling. The people with stroke underwent the following assessments in a random order: the BSE, Fugl-Meyer Assessment of Lower Extremity (FMA-LE), muscle strength of plantar flexors and dorsiflexors, Montreal Cognitive Assessment, Berg Balance Scale, Limit of Stability (LOS), Foot and Ankle Ability Measure (FAAM), 12-Item Short Form Survey (SF-12) version 2, and Oxford Participation and Activities Questionnaire (Ox-PAQ). The healthy older adults were assessed with BSE.
Results
The BSE scale demonstrated good test-retest reliability (intraclass correlation coefficient= 0.796) with minimal detectable change at a 95% confidence interval of 433.74 and cut-off score of 1,225, which best differentiated between people with stroke and healthy older adults. The BSE score was significantly correlated with the FMA-LE score, muscle strength of the affected side ankle dorsiflexor and plantar flexor, LOS parameter, FAAM, SF- 12, and Ox-PAQ scores.
Conclusion
The BSE scale is a reliable clinical tool with good test-retest reliability. The BSE scores were significantly correlated with other outcome measures that assess motor functions, balance, and quality of life. It is a simple and easy-to-administer outcome measure for assessing BSE in people with stroke.

Objective
To investigate the impact of self-efficacy in using one’s upper limbs on the overall wellbeing of stroke patients, we developed the Korean version of the Confidence of Arm and Hand Movement (K-CAHM) scale by modifying the original CAHM to suit Korean cultural conditions.
Methods
This study was conducted from May 2022 to June 2023 at a rehabilitation hospital with 54 stroke patients. Participants with sufficient cognitive and verbal abilities were included, while those with severe comorbidities were excluded. For the translation and cultural adaptation of CAHM into Korean, permission was obtained from the original author. Two translators independently translated the questionnaire, followed by a consensus discussion and expert review to create K-CAHM version 1.0. After back-translation and further review, the final Korean version was completed. Reliability and validity were assessed using Cronbach’s alpha, intraclass correlation coefficient (ICC), exploratory factor analysis, Bland–Altman analysis, and Pearson correlation.
Results
The K-CAHM showed good reliability (Cronbach’s alpha=0.97; ICC=0.895). Bland–Altman plot analysis showed good agreement, indicating test-retest reliability. Moreover, K-CAHM showed good concurrent validity, demonstrated by its correlation with three domains of the International Classification of Functioning, Disability and Health: Fugl-Meyer assessment, the Jebsen-Taylor Hand Function Test, personal hygiene and bathing in the modified Barthel Index, and hand and stroke recovery domain in the Stroke Impact Scale.
Conclusion
The newly developed K-CAHM could complement other outcome measures, facilitating patient-centered rehabilitation in the Korean context.

Objective
To determine the effects of the Paraplegia Fitness Integrated Training (PARAFiT) program, which is an integrated graded physical exercise and health education program for individuals with spinal cord injury (SCI).
Methods
This nonrandomized single-blind study included 44 participants, who were assigned to either an intervention (PARAFiT) group or an active control (conventional physiotherapy) group. The intervention group underwent the PARAFiT program (8 weeks), which consisted of circuit-based interval training, progressive upper limb resistance training, and health education sessions. During the unsupervised period, the intervention group continuously underwent health education program once a month for 2 months (8 weeks). Repeated-measures analysis of variance was used for the analysis.
Results
The intervention group presented with a higher level of physical activity than did the control group; however, the difference was not significant (p=0.36). Additionally, the intervention group presented with better exercise self-efficacy and cardiorespiratory fitness and stronger bilateral shoulder muscle and handgrip than did the control group (all p<0.05). Exercise adherence was higher in the intervention group than in the control group during both the supervised (80% vs. 75%) and unsupervised (40% vs. 20%) periods.
Conclusion
The PARAFiT program enhanced the level of physical activity, exercise self-efficacy, physical fitness, and exercise adherence among the patients with SCI. Future studies should incorporate guidelines for home-based exercises and regular monitoring to promote long-term adherence to exercise and physical activity among individuals with SCI.

Citations

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• Reliability and Validity of the Japanese Version of the Exercise Self‐Efficacy Scale in Older People Undergoing Lower Extremity Arthroplasty
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• Feasibility, Usability, and Safety of ParaGym, an Intelligent Mobile Exercise App for Individuals With Paraplegia: Protocol for a Pilot Block-Randomized Controlled Trial
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