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

Verheyden, Geert; Nieuwboer, Alice; Wit, Liesbet De; Feys, Hilde; Schuback, Birgit; Baert, Ilse; Jenni, Walter; Schupp, W.; Thijs, Vincent; Weerdt, Willy De

doi:10.1136/jnnp.2006.101642

Cited by 167 publications

(148 citation statements)

References 23 publications

(20 reference statements)

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“…Good ability to predict function over time was furthermore demonstrated in patients with sub-acute stroke [24].…”

mentioning

confidence: 92%

The Trunk Impairment Scale – modified to ordinal scales in the Norwegian version

Gjelsvik¹,

Breivik²,

Verheyden³

et al. 2011

Disability and Rehabilitation

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Purpose: To translate the Trunk Impairment Scale (TIS), a measure of trunk control in patients with stroke, into Norwegian (TIS-NV), and to explore its construct validity, internal consistency, intertester and test-retest reliability. Method:The TIS was translated according to international guidelines. 201 patients with acute stroke were recruited for the validity study, and 50 inpatients with acquired brain lesions were recruited for the study of intertester and test-retest reliability.Construct validity was analysed using explorative factor analysis, confirmatory factor analysis and item response theory, internal consistency with Cronbach's alpha test, and intertester and test-retest reliability with kappa and intraclass correlation coefficient tests. Results:The back-translated version of TIS-NV was validated by the original developer. The subscale Static sitting balance was removed from the test. Six testlets were hierarchically constructed by combining items from the subscales Dynamic sitting balance and Coordination, and renamed modified TIS-NV (TIS-modNV). After these modifications the TIS-modNV fitted well to a locally dependent unidimensional item response theory model. The test demonstrated good construct validity, excellent internal consistency, as well as high intertester and test-retest reliability for the total score. Conclusions:The TIS-modNV is a valid and reliable scale for use in clinical practice and research.3 Main textPatients with disability due to neurological lesions constitute one of the greatest challenges for society and health services in developed countries [1]. The most common cause of brain damage in adults is stroke, and in Norway approximately 15.000 persons suffer a stroke each year [2]. Rehabilitation should be beneficial for the individual patient as well as for society [3], and adequate assessment tools are needed to examine relevant functional aspects.Impaired balance is a common physical deficit post stroke [4;5], and improved balance has been found to be associated with improved rehabilitation outcomes [6], ability to perform daily activities [7], and walking [8]. Impaired balance increases the risk of falls [9], and may thus imply social problems and high economic costs [10].The trunk seems particularly important for balance as it stabilizes the pelvis and spinal column [11], being a prerequisite for coordinated use of the extremities in functional activities such as reaching and gait [12]. Impaired trunk control seems common post stroke [13], and trunk control assessed in patients early after stroke has been found predictive of long-term functional improvement [14;15] Even if previous studies using CTT have given important psychometric information, there are several problems with the assumptions underlying CTT such as sample dependency, item equivalence and standard error of measurement [25]. If the data can meet certain rather strict assumptions, Item Response Theory (IRT) overcomes many of these limitations [26;27]. IRT also provides rather sophisticated psyc...

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“…Good ability to predict function over time was furthermore demonstrated in patients with sub-acute stroke [24].…”

mentioning

confidence: 92%

The Trunk Impairment Scale – modified to ordinal scales in the Norwegian version

Gjelsvik¹,

Breivik²,

Verheyden³

et al. 2011

Disability and Rehabilitation

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show abstract

“…According to several studies, trunk control ability can be improved by performing specific exercise training (Howe et al 2005;Verheyden et al 2007;Saeys et al 2012). A study by Verheyden et al (2009) showed that 10 hours of additional trunk exercises improved the ability to control the trunk in subacute stroke patients, and reaching exercises performed while seated were reported to improve sitting balance, peak vertical force on the paretic foot, and gait speed in chronic hemiplegic patients (Dean et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Weight-Shift Training Improves Trunk Control, Proprioception, and Balance in Patients with Chronic Hemiparetic Stroke

Jung

Kim

Chung

et al. 2014

Tohoku J. Exp. Med.

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Trunk instability is one of main problems in survivors following stroke. We investigated the effects of weight-shift training (WST) on an unstable surface in sitting position on trunk control, proprioception, and balance in individuals with chronic hemiparetic stroke. Eighteen participants with chronic hemiparetic stroke were recruited and were allocated to either WST or control group. The WST group received a weight-shift training program for 30 min and then received a conventional exercise program for 30 min, while the control group received conventional exercise program for 60 min, five times a week for four weeks for both groups. In this randomized control study, we used three outcome measures: trunk reposition error (TRE), Trunk Impairment Scale (TIS), and Timed Up and Go (TUG) test. TRE was measured by each participant's reposition error to the target angle during his/her active trunk movement. TIS and TUG were examined for trunk control abilities and dynamic balance abilities, respectively. After training, TRE showed significantly greater improvement in the WST group (mean change, 1.67 ± 1.45˚) than the control group (mean change, 0.08 ± 1.05˚). The TIS score was significantly higher in the WST group (mean change, 2.33 ± 1.50) than the control group (mean change, 0.13 ± 0.83). The TUG test also showed a significant improvement in the WST group (mean change, 5.03 ± 1.88 sec) than the control group (mean change, 2.59 ± 1.86 sec). Our findings indicate that weight-shift training is beneficial for improving trunk control and proprioception in patients with chronic hemiparetic stroke.

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“…Trunk control has been found to be associated with balance and functional ability [31,32], functional change and destination at discharge [33], and to predict functional outcome at 6 months post stroke better than Barthel Index [34]. Trunk impairments may potentially be one explanatory factor for the patients' level of disability post stroke as seen in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

Gjelsvik

Strand²,

Næss³

et al. 2014

Int J Phys Med Rehabil

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

Cited by 167 publications

References 23 publications

The Trunk Impairment Scale – modified to ordinal scales in the Norwegian version

The Trunk Impairment Scale – modified to ordinal scales in the Norwegian version

Weight-Shift Training Improves Trunk Control, Proprioception, and Balance in Patients with Chronic Hemiparetic Stroke

Trunk Control and Lesion Locations According to Alberta Stroke Program Early CT Score in Acute Stroke: A Cross-Sectional Study

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