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. 2022 Nov 24;19(23):15644.
doi: 10.3390/ijerph192315644.

The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis

Kumar Gular  1   2 , Viswanathan Sivasubramanian  1 , Ravi Shankar Reddy  2 , Jaya Shanker Tedla  2 , Snehil Dixit  2
Affiliations

The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis

Kumar Gular et al. Int J Environ Res Public Health. .

Abstract

Background: The trunk acts as proximal support with which limbs execute smooth and purposeful movement. Furthermore, as upper extremity functions are an integral component of daily living activities, exploring the association between trunk and upper extremity recovery will guide therapists in developing appropriate rehabilitation goals and interventions. The objectives of this study were to (1) assess the association between trunk and upper extremity recovery in the subacute stroke population and (2) assess the effect of trunk control on upper extremity impairment and function with age, gender, and duration of stroke as mediators using mediation analysis in subacute stroke individuals.

Methods: This cross-sectional study included 54 subacute stroke participants with a mean age of 58.37 ± 6.11 years. The trunk impairment scale (TIS) assessed the trunk's stability, mobility, and coordination. The level of upper extremity impairment was evaluated using the Fugl-Meyer Assessment scale (FMA). The quality and quantity of upper limb motor functions were measured using the Wolf motor function test (WMFT).

Results: The TIS exhibited moderate positive correlations with the FMA-UE, WMFT-time scale (TS), and WMFT-functional ability scale (FAS) at p < 0.001. The mediation analysis reported a profound mediation effect of post-stroke duration on the association of trunk and upper limb recovery.

Conclusions: The study results substantiated that trunk control significantly correlates with upper limb impairment and the quality and quantity of its use in the subacute stroke population. Post-stroke duration proved to mediate the association between trunk and upper limb recovery. Therefore, the assessment and intervention of trunk and upper extremity motor control considering the post-stroke duration is vital and should be incorporated in stroke rehabilitation aiming at functional independence.

Keywords: hand functions; subacute stroke; trunk control; upper limb impairment.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Figure 1
Figure 1
Mediation model including age, gender, and post-stroke duration as control variables.
Figure 2
Figure 2
Correlation between trunk control (TIS) and (A) FMA-upper extremity, (B) WMFT-Time score and score, and (C) WMFT-Functional ability scale. Dashed line = regression line.
See this image and copyright information in PMC

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