Studying turn performance, trunk control, and mobility in acute stroke subjects: a cross-sectional study

Stroke leads to various impairments like motor deficits, impaired trunk control and restricted mobility. However, rehabilitation professionals often underestimate the fundamental function of turning, which is essential for daily living activities like walking, cooking, or performing household chores. Impaired turning can be attributed to motor deficits post-stroke, resulting in restricted mobility and impaired trunk movement. Therefore, the present study aimed to determine the relationship between turn performance, trunk control, and mobility in stroke patients.

A total of 63 first-time supratentorial stroke (i.e., anterior circulation stroke) patients aged 18-90 years were recruited for the study. Turn performance was assessed by asking patients to walk for 10 feet comfortably, then take a 180° turn and return to the starting position. In addition, the duration and number of steps were recorded. Following this, the Trunk Impairment Scale (TIS) and Stroke Rehabilitation Assessment of Movement (STREAM) were used to assess trunk impairment and mobility, respectively. The group turn performance was analyzed using the Kruskal-Wallis test with a post hoc Mann-Whitney U test for between-group comparisons. The turn duration and turn steps were correlated with age, trunk control, and mobility using Spearman's rank correlation. A regression analysis was performed to determine the association of turn performance with age, trunk control, and mobility among stroke patients.

Thirty stroke patients had turning difficulty, and 33 did not. Hence, they were categorized into the turning difficulty (TD) and non-turning difficulty (NTD) groups. When correlated with turn duration and the number of steps taken by the stroke patients while turning, the STREAM and TIS scores revealed a significant negative correlation (p < 0.001). The subjects' age showed a significant positive correlation with the turn duration and number of steps taken by stroke patients while turning (p < 0.001). A significant association was also found between turn performance and age and trunk control. However, there was no significant association between turn performance and mobility.

The observed associations highlight the complexity of turning ability and trunk control necessary to complete a turn safely. Additionally, with advancing age, turn performance and turning movement are compromised in stroke patients. This indicates that turning difficulty is more pronounced in older individuals with stroke.