Trunk performance after stroke and the relationship with balance, gait and functional ability

Area of Science:

• Neurorehabilitation
• Movement Science
• Clinical Assessment

Background:

• Trunk performance is crucial for balance, gait, and functional mobility after stroke.
• Existing assessments like the Trunk Control Test (TCT) may have ceiling effects, limiting their utility in chronic stroke.
• The Trunk Impairment Scale (TIS) is a newer tool for evaluating trunk control.

Purpose of the Study:

• To evaluate trunk performance in non-acute and chronic stroke patients using the Trunk Control Test (TCT) and Trunk Impairment Scale (TIS).
• To compare the TCT and TIS in relation to balance, gait, and functional ability.
• To identify the most sensitive measures for assessing trunk control post-stroke.

Main Methods:

• Fifty-one stroke patients in a rehabilitation program were assessed.
• Evaluated using the Trunk Control Test (TCT), Trunk Impairment Scale (TIS), Tineti balance and gait subscales, Functional Ambulation Category (FAC), 10-m walk test, Timed Up and Go (TUG) test, and the motor component of the Functional Independence Measure (FIM).

Main Results:

• Patients scored a median of 61/100 on the TCT and 11/23 on the TIS.
• Only 24% achieved maximum TCT score, while no patient reached maximum TIS score, indicating a ceiling effect for the TCT.
• Trunk performance measures significantly correlated with balance, gait, and functional ability.
• The TIS dynamic sitting balance subscale, in addition to the TCT total score, significantly predicted gait and functional ability (model R² = 0.55–0.62).

Conclusions:

• Trunk performance remains impaired in both non-acute and chronic stroke patients.
• The Trunk Impairment Scale (TIS) is advantageous for future studies due to its lack of a ceiling effect.
• The TIS, particularly its dynamic sitting balance component, provides valuable insights into functional recovery post-stroke.