The Impact of Trunk Function and Lower Limb Paralysis on Independence in Activities of Daily Living Among Stroke Patients

TL;DR

This study shows that combining assessments of trunk function and lower limb paralysis better predicts daily living independence in stroke patients.

Contribution

The study introduces a combined assessment method for trunk and lower limb function in stroke rehabilitation.

Findings

Combined assessment of trunk and lower limb function improved ADL independence prediction accuracy.

Individual assessments of trunk or lower limb function were less effective than combined evaluation.

Abstract

Background: Stroke is a major global health issue, and many patients experience motor paralysis and sensory impairments that affect their independence in the activities of daily living (ADLs). Trunk and lower limb functions are crucial in poststroke ADL independence. Although these two functions are closely related, a few studies have evaluated them in combination, and the importance of assessment methods that consider their mutual relationship has not been thoroughly examined. In this study, we aimed to clarify the degree to which trunk function and lower limb paralysis impact ADL independence when evaluated individually versus in combination, through a hierarchical regression analysis, and to verify the significance of the combined assessment of both functions.

Methods: This cross-sectional study included 51 patients with first-ever stroke and hemiplegia. Trunk function was assessed using the Trunk Impairment Scale, lower limb paralysis was evaluated using the Brunnstrom recovery stage for the lower extremities, and ADL independence was measured using the Functional Independence Measure. Hierarchical regression analysis was conducted to examine the impact of trunk and lower limb functions on ADL independence.

Results: Across two regression models, the assessment of trunk and lower limb function in combination significantly improved the accuracy in reflecting ADL independence compared with the assessment of each function individually (p < 0.05).

Conclusions: The combined evaluation method, which assesses both trunk function and lower limb motor paralysis, more accurately reflected ADL independence, suggesting its usefulness as an assessment method in the rehabilitation of patients with stroke.