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Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy

Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy
Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy
Background: Trunk control is thought to contribute to upper extremity (UE) function. However, this common assumption has not been validated.

Objective: To investigate the effect of providing an external trunk support on trunk control and UE function, and examine the relationship between trunk control and UE function in people with chronic stroke and healthy controls.

Design: A cross-sectional study was conducted.

Methods: Twenty-five participants with chronic stroke and 34 age and sex-matched healthy controls were recruited. Trunk control was assessed using the Trunk Impairment Scale (TIS), UE impairment and function were assessed with Fugl-Meyer (FMA-UE) and Streamlined Wolf Motor Function Test (SWMFT) respectively. The TIS and SWMFT were evaluated, with and without an external trunk support; the FMA was evaluated without trunk support.

Results: With trunk support, participants with stroke demonstrated improvement in TIS from 18 to 20 points (p<0.001); reduction in SWMFT performance time (SWMFT-Time) of the affected UE from 37.20 to 35.37 seconds (p<0.05); and improvement in the affected UE function (SWMFT-Functional Ability Scale) from 3.3 to 3.4 points (p<0.01). With trunk support, SWMFT-Time of healthy controls was reduced from 1.61 to 1.48 seconds (p<0.001) for the dominant, and from 1.71 to 1.59 seconds (p<0.001) for the non-dominant UE. Significant moderate correlation was found between TIS and FMA-UE (r = 0.53) in participants with stroke.

Limitations: The limitations include a non-blinded assessor and a standardized height of the external trunk support.

Conclusions: External trunk support improved trunk control in people with chronic stroke; and had a statistically significant effect on UE function in both people with chronic stroke and healthy controls. The findings suggest an association between trunk control and UE when an external trunk support was provided. This supports the hypothesis that the provision of lower trunk and lumbar stabilization from an external support enables an improved ability to use the UE for functional activities.
0031-9023
1163-1171
Wee, S.K.
9a424121-debd-44c1-ad67-ee391e6da101
Hughes, A.-M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Warner, M.B.
f4dce73d-fb87-4f71-a3f0-078123aa040c
Brown, S.
81f6a7a5-379f-4b86-8b55-39f9799c23c8
Cranny, A.
2ebc2ccb-7d3e-4a6a-91ac-9f089741939e
Mazomenos, E.B.
23983827-c7e7-4ee1-bfc8-986aa3594279
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Wee, S.K.
9a424121-debd-44c1-ad67-ee391e6da101
Hughes, A.-M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Warner, M.B.
f4dce73d-fb87-4f71-a3f0-078123aa040c
Brown, S.
81f6a7a5-379f-4b86-8b55-39f9799c23c8
Cranny, A.
2ebc2ccb-7d3e-4a6a-91ac-9f089741939e
Mazomenos, E.B.
23983827-c7e7-4ee1-bfc8-986aa3594279
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64

Wee, S.K., Hughes, A.-M., Warner, M.B., Brown, S., Cranny, A., Mazomenos, E.B. and Burridge, J.H. (2015) Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy. Physical Therapy, 95 (8), 1163-1171. (doi:10.2522/ptj.20140487).

Record type: Article

Abstract

Background: Trunk control is thought to contribute to upper extremity (UE) function. However, this common assumption has not been validated.

Objective: To investigate the effect of providing an external trunk support on trunk control and UE function, and examine the relationship between trunk control and UE function in people with chronic stroke and healthy controls.

Design: A cross-sectional study was conducted.

Methods: Twenty-five participants with chronic stroke and 34 age and sex-matched healthy controls were recruited. Trunk control was assessed using the Trunk Impairment Scale (TIS), UE impairment and function were assessed with Fugl-Meyer (FMA-UE) and Streamlined Wolf Motor Function Test (SWMFT) respectively. The TIS and SWMFT were evaluated, with and without an external trunk support; the FMA was evaluated without trunk support.

Results: With trunk support, participants with stroke demonstrated improvement in TIS from 18 to 20 points (p<0.001); reduction in SWMFT performance time (SWMFT-Time) of the affected UE from 37.20 to 35.37 seconds (p<0.05); and improvement in the affected UE function (SWMFT-Functional Ability Scale) from 3.3 to 3.4 points (p<0.01). With trunk support, SWMFT-Time of healthy controls was reduced from 1.61 to 1.48 seconds (p<0.001) for the dominant, and from 1.71 to 1.59 seconds (p<0.001) for the non-dominant UE. Significant moderate correlation was found between TIS and FMA-UE (r = 0.53) in participants with stroke.

Limitations: The limitations include a non-blinded assessor and a standardized height of the external trunk support.

Conclusions: External trunk support improved trunk control in people with chronic stroke; and had a statistically significant effect on UE function in both people with chronic stroke and healthy controls. The findings suggest an association between trunk control and UE when an external trunk support was provided. This supports the hypothesis that the provision of lower trunk and lumbar stabilization from an external support enables an improved ability to use the UE for functional activities.

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Accepted/In Press date: 17 February 2015
e-pub ahead of print date: 26 February 2015
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 381008
URI: http://eprints.soton.ac.uk/id/eprint/381008
ISSN: 0031-9023
PURE UUID: ce4a8847-0c0b-40f7-88ee-8b4ec129f04c
ORCID for A.-M. Hughes: ORCID iD orcid.org/0000-0002-3958-8206
ORCID for M.B. Warner: ORCID iD orcid.org/0000-0002-1483-0561
ORCID for S. Brown: ORCID iD orcid.org/0000-0001-9646-3285
ORCID for J.H. Burridge: ORCID iD orcid.org/0000-0003-3497-6725

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Date deposited: 27 Aug 2015 15:34
Last modified: 15 Mar 2024 03:25

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Contributors

Author: S.K. Wee
Author: A.-M. Hughes ORCID iD
Author: M.B. Warner ORCID iD
Author: S. Brown ORCID iD
Author: A. Cranny
Author: E.B. Mazomenos
Author: J.H. Burridge ORCID iD

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