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

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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Identifiers

ORCID for A.-M. Hughes: orcid.org/0000-0002-3958-8206

ORCID for M.B. Warner: orcid.org/0000-0002-1483-0561

ORCID for S. Brown: orcid.org/0000-0001-9646-3285

ORCID for J.H. Burridge: orcid.org/0000-0003-3497-6725

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