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Companion Confidence in the Balance of Community-Dwelling Older Adults: Implications for Physical Activity Promotion

Cavanaugh, James T. PT, PhD1; Dunfey, Julia C. PT, DPT2; Wyand, Megan K. PT, DPT3

Journal of Geriatric Physical Therapy: July/September 2014 - Volume 37 - Issue 3 - p 121–126
doi: 10.1519/JPT.0b013e3182abe7c0
Research Reports

Background and Purpose: Positive social relationships may increase the intention of older adults to be physically active. In the presence of balance impairments, however, the potential influence of a familiar companion on an older adult's physical activity is not well understood. The purpose of this preliminary investigation was to explore companion confidence in the balance capability of an older adult as a potential determinant of older adult physical activity.

Methods: The study employed a cross-sectional design, in which 40 dyads formed by a community-dwelling older adult and his or her close companion (eg, family member, friend, and caregiver) were recruited as a sample of convenience. Older adults completed the Activities-Specific Balance Confidence (ABC) scale and the Physical Activity Survey for the Elderly (PASE). Companions completed a modified version of the ABC scale, in which they were asked to rate their confidence in the older adult's balance. The agreement between and correspondence of paired ABC scores were analyzed using mean difference (95% confidence interval [CI]), dependent samples t test (α = 0.05), and the intraclass correlation coefficient 1-way random effects model. The Pearson product-moment correlation coefficient was used to characterize the relationship between companion confidence and older adult physical activity.

Results: Older adults were more confident in their balance capability (mean ABCOlder Adult = 70.0; 95% CI = 62.8−77.2) than their companions (mean ABCCompanion = 60.2; 95% CI = 50.6−69.8). The difference between group mean scores was significant (mean difference = 9.8; 95% CI = 2.3−17.3, t (39) = 2.38; P = 0.02). Discordance increased as the mean of paired ABC scores diminished. ABC scores were also significantly yet moderately associated (intraclass correlation coefficient (1,1) = 0.56; 95% CI = 0.31−0.74; P < 0.01). The association between ABCCompanion and PASE scores was stronger (r = 0.51; 95% CI = 0.23−0.79; P < 0.01) than the association between ABCOlder Adult and PASE scores (r = 0.33; 95% CI = 0.02−0.64; P = 0.04) and increased in cases for which companions were markedly less confident than older adults.

Discussion and Conclusions: Older adults and their companions did not necessarily share similar confidence in the older adult's balance capability. Companion confidence, especially when markedly less than older adult confidence, showed promise as a predictor of older adult physical activity. Study findings provided a foundation for future investigations that examine the effect of social relationships on the physical activity self-efficacy of older adults with balance impairments.

1Department of Physical Therapy, University of New England, Portland, Maine.

2Coastal Rehab, LLC, Cape Elizabeth, Maine.

3Spaulding Nursing and Therapy Center North End, Boston, Maine.

Address correspondence to: James T. Cavanaugh, PT, PhD, Department of Physical Therapy, University of New England, 716 Stevens Ave., Portland, ME 04103 (

This work was sponsored by the Department of Physical Therapy, University of New England, Portland, Maine.

The authors declare no conflicts of interest.

Robert Wellmon was the Decision Editor.

Copyright © 2014 the Section on Geriatrics of the American Physical Therapy Association
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