Does trunk, arm, or leg control correlate best with overall function in stroke subjects?

Abstract

Background: Attainment of functional independence is the ultimate goal of a sound stroke rehabilitation program. Good trunk stability is essential for balance and extremity use. Stroke patients may have upper extremity impairments that may affect functional activity and lower extremity impairments that may hinder mobility. Hence, quantifying the specific levels of impairment in the trunk, upper extremity, and lower extremity is helpful to determine the extent to which each might influence the ability to perform activities of daily living.

Objective: To assess the impairment of the trunk and the upper and lower extremity of stroke patients and correlate it with overall function.

Methods: A cross-sectional repeated correlation study. Twenty-three subjects with a first-time stroke, between 50 and 75 years of age, of both genders, admitted in hospital within 5 weeks of stroke onset were included using purposive sampling technique. On the eighth day of the stroke, trunk impairment was assessed using the Trunk Impairment Scale, upper and lower limb impairment was assessed using the Simplified Stroke Rehabilitation Assessment of Movement (upper and lower limb subscale, respectively), and overall function was measured by FIM.

Results: Trunk activity showed highly significant correlation (r = 0.598, P = .003) with overall function compared with upper limb activity (r = 0.501, P = .015). Lower limb impairment showed no correlation with overall function (r = 0.208, P = .342).

Conclusions: The overall functional independence in acute stroke patients is most closely correlated with the levels of impairments of trunk function, followed by upper limb impairments.