Trunk Control as an Early Predictor of Comprehensive Activities of Daily Living Function in Stroke Patients

Abstract

Background and Purpose-Prediction of activities of daily living (ADL) functions at an early stage after a stroke is critical because it enables clinicians to set treatment programs and goals. The objective of this study was to assess the relationship between trunk control at an early stage and comprehensive ADL function (as assessed by combining basic ADL and instrumental ADL [IADL]) in patients at 6 months after stroke. Methods-A total of 169 stroke patients participated in this prospective study. Trunk control was measured with the use of the trunk control items of the Postural Assessment Scale for Stroke Patients (PASS-TC). In addition to the PASS-TC score, age, sex, type of stroke, side of hemiparesis, urinary incontinence, limb paresis (measured by the Fugl-Meyer motor test), balance (measured by the Fugl-Meyer balance test), and basic ADL (measured by the Barthel Index) were also selected as predictor variables. These variables were assessed at 14 days after stroke or earlier. The Barthel Index and Frenchay Activities Index (measuring IADL) were administered at 6 months after stroke. The sum of the standardized Barthel Index and standardized Frenchay Activities Index scores was used to assess comprehensive ADL function. Results-Multivariable stepwise linear regression analysis showed that PASS-TC score, age, Fugl-Meyer motor test score, and Barthel Index score (listed by the order of forward selection) were the strongest predictors of comprehensive ADL function. These results were internally validated with the use of the bootstrap resampling technique. The PASS-TC score alone accounted for 45% of the variance in predicting comprehensive ADL function. Results also indicated that the PASS-TC score had slightly more power in predicting comprehensive ADL function than either the Fugl-Meyer motor test score or Barthel Index score. Conclusions-The findings of this study provide strong evidence of the predictive value of trunk control on comprehensive ADL function in stroke patients. The results imply that early assessment and management of trunk control after stroke should be emphasized.

Effects of Scapular Stabilization Exercise on Function of Paretic Upper Extremity of Chronic Stroke Patients

“…Postural control of the trunk is also a critical component of independent performance of activities of daily living. Hsieh et al investigated the relationship between trunk control and comprehensive activities of daily living 10) . Stoykov et al examined the effect of postural control training on the prehensile function of the paretic upper limb 11) .…”

Alterações eletromiográficas dos músculos do tronco de pacientes com hemiparesia após acidente vascular encefálico

“…No presente estudo, os indivíduos com hemiparesia apresentaram diferenças na ativação muscular em comparação com o grupo controle, no entanto, os participantes desta amostra apresentaram uma alta pontuação na escala de funcionalidade. Alguns estudos 16,17 indicaram que o controle de tronco é um importante preditor da funcionalidade após o Ave, mas indivíduos crônicos são capazes de adaptar-se, como por exemplo, aumentando a mobilidade do tronco superior e diminuindo o deslocamento da pelve 18 ou realizando movimentos em massa 3 , o que diminui o impacto das alterações motoras do tronco nas atividades de vida diária.…”

Rehabilitación del control de tronco en pacientes con accidente cerebrovascular mediante una interfaz inercial: Resultados preliminares

“…Sin embargo, a pesar de las pruebas convincentes de que el rendimiento del tronco es un importante predictor del resultado funcional después del ACV, las investigaciones que evalúan los resultados de la rehabilitación específica de este segmento son limitadas [12][13][14].…”