| Abstract |1 )PURPOSE: The initiation of the trunk muscles in stroke patients is delayed because the muscles involved in reach arm are activated earlier than the trunk muscles. The objective of this study was to examine the effects of mobility, balance, and trunk control ability through selective trunk exercise (STE) in patients with chronic stroke. METHODS:A randomized pre-test and post-test control group design was initially used, with subjects randomly assigned to the STE group (n=15) and a control group (n=14).All groups underwent physical therapy based on the neuro-developmental therapy (NDT) for 30 minutes a day, five times per week for four weeks. Additionally, the STE group did the trunk exercise for 30 minutes a day, three times per week for four weeks. The timed up and go test (TUG), Berg balance scale (BBS), and trunk impairment scale (TIS) were used for assessment. RESULTS:The scores of the TUG, BBS, dynamic sitting balance subscale, and coordination subscale of TIS improved significantly in both groups but the improvement was more †Corresponding Author : daeric@konyang.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. pronounced in the STE group (p<.05). This study showed a large effect on the scores of the TIS coordination subscale (d=.93) (p<.05), TIS dynamic balance subscale (d=.81) (p<.05), TUG (d=.75) (p<.05), and BBS (d=.73) (p<.05). CONCLUSION:The combined STE and NDT program showed improvements in measures of mobility, balance, and trunk control in chronic stroke patients. These results suggest that STE should be considered to be included in the treatment program for patients with chronic stroke.

Gait speed and walking distance were evaluated as predictors for levels of community walking after stroke. In this study, 103 stroke survivors were identified as limited (n = 67) or independent community walkers (n = 36). Ten meter and six min walk tests were used to measure gait speed and walking distance, respectively. The discriminative properties of gait speed and walking distance for community walking were investigated using receiver operating characteristic curves. Cut-off values of 0.87 m/s for community walking gait speed for walking distance had positive predictive values of 65% and 55%, respectively. The negative predictive value ranged from 89% for gait speed to 79% for walking distance. Gait speed and walking distance showed significant differences between limited and independent community walking. Gait speed was more significantly related to community walking than walking distance. The results of this study suggest that gait speed is a better predictor for community walking than walking distance in moderately affected post-stroke survivors.

Objective To investigate the relationship between sitting balance, trunk control, and mobility, as well as whether the sitting balance and trunk control can predict mobility level in sub-acute stroke survivors. Methods This is a observational and cross-sectional study. Fifty-five hemiplegic stroke survivors were participated in this study. The Timed Up and Go Test (TUG) was used to estimate mobility, and the Sitting Balance Scale (SBS) was used to examining sitting balance. The Trunk Impairment Scale (TIS), Trunk Control Test (TCT), and Postural Assessment Scale for Stroke-trunk control (PASS-TC) were used for examining the trunk control. Spearman’s correlation was used to analyze the relationship between TUG, SBS, TIS, TCT, and PASS-TC. Results The TUG is significantly correlated with SBS (r = -0.78), TIS (r = -0.76), TCT (r = -0.65), and PASS-TC (r = -0.67). In addition, the receiver operation characteristic (ROC) curve showed as cut-off value of SBS as >28.5, TIS > 16.5, TCT >82, and PASS-TC >10.5. The area under the ROC curve in each of the four tests is moderately accurate for predicting the mobility of sub-acute stroke survivors (0.84 ~0.90) (0.7 < AUC ≤ 9 (moderate informative)). Implications The SBS showed the highest correlation for mobility using TUG in the hemiplegic stroke survivors. Also, SBS was revealed as the most dominant examination tool predicting the mobility by TUG, it can be explained the sitting postural balance is the variable predicting the mobility in survivors of sub-acute stroke.

[Purpose] The present study aimed to investigate the discriminative validity of the short-form activities-specific balance confidence scale (ABC scale) in predicting falls, and its validity. [Subjects and Methods] 43 stroke survivors were identified as a group with a history of multiple falls (faller group) and a group without or with a history of one falls (non-faller group). The balance confidence was examined using the ABC scale and the short-form ABC scale. Functional abilities were examined with Fugl-Meyer assessment, sit-to-stand test, and Berg balance scale. [Results] The area under the curve of the ABC scale and the short-form ABC scale in predicting fall was>0.77. This result indicates that both examination tools have discriminative validity in predicting falls. Although both tools showed an identical predictable specificity of 72% in the non-faller and faller groups, the short-form ABC scale exhibited a predictable sensitivity of 86% in the faller group, which is higher than that of the ABC scale (71%). [Conclusion] Results of this study showed that the short-form ABC scale is an efficient clinical tool to evaluate and predict the balance confidence of stroke survivors.

Falling is one of the most common complications in stroke survivors. It is therefore important to evaluate the risk of falls. In this study, we investigated the usability of the performance-oriented mobility assessment (POMA) for predicting falls in stroke patients. The POMA examines the level of balance and mobility. Data were collected on the number of falls and physical functions from 72 stroke survivors. Physical functions were measured using the POMA balance subscale, One Leg Stand test (OLS), Sit To Stand test (STS), 10-m Walk Test (10WT), Fugl-Meyer assessment (FM), and Trunk Impairment Scale (TIS). Since the accuracy of the POMA balance subscale was moderate, the cutoff value used for predicting falls was 12.5 points (sensitivity: 72%; specificity: 74%), and the area under the curve was 0.78 (95% confidence interval: 0.66-0.91, p < 0.001). When comparing the physical functions (i.e., OLS, STS, 10WT, FM, and TIS) to the cutoff value for the POMA balance subscale, the physical functions of the group over 12.5 points for the subscale were significantly higher than those in the group below 12.5 points (p < 0.05). The muscle strength shown in the STS was the most important factor affecting the performance in the POMA balance subscale (β = −0.447). For the group below 12.5 points on the POMA balance subscale, the risk of falling increased by 0.304 times more than the group over 12.5 points. The POMA balance subscale is a valid tool for assessing the physical function and fall risk of stroke survivors.