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Trunk performance after stroke: an eye catching predictor of functional outcome

¹ Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
² Rehaclinic Zurzach, Quellenstrasse, Zurzach, Switzerland
³ Fachklinik Herzogenaurach, In der Reuth 1, Herzogenaurach, Germany
⁴ Department of Neurology, UZ Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium

Correspondence to:
Correspondence to:
Dr Geert Verheyden
University of Southampton, School of Health Professions and Rehabilitation Sciences, Southampton General Hospital, Mailpoint 886, Tremona Rd, Southampton SO16 6YD, UK; G.Verheyden{at}soton.ac.uk

Background and aim: Trunk performance is an important predictor of functional outcome after stroke. However, the percentage of explained variance varies considerably between studies. This may be explained by the stroke population examined, the different scales used to assess trunk performance and the time points used to measure outcome. The aim of this multicentre study was to examine the predictive validity of the Trunk Impairment Scale (TIS) and its subscales when predicting the Barthel Index score at 6 months after stroke.

Methods: A total of 102 subjects were recruited in three European rehabilitation centres. Participants were assessed on admission (median time since stroke onset 20 days) and 6 months after stroke. Correlation analysis and forward stepwise multiple regression analysis were used to model outcome.

Results: The best predictors of the Barthel Index scores at 6 months after stroke were total TIS score (partial R² = 0.52, p<.0001) and static sitting balance subscale score (partial R² = 0.50, p<.0001) on admission. The TIS score on admission and its static sitting balance subscale were stronger predictors of the Barthel Index score at 6 months than the Barthel Index score itself on admission.

Conclusions: This study emphasises the importance of trunk performance, especially static sitting balance, when predicting functional outcome after stroke. The TIS is recommended as a prediction instrument in the rehabilitation setting when considering the prognosis of stroke patients. Future studies should address the evolution of trunk performance over time and the evaluation of treatment interventions to improve trunk performance.

Abbreviations: ADL, activities of daily living; TIS, Trunk Impairment Scale