Comparative Analysis of Trunk Impairment Scale vs. Sitting Balance Scale to Predict Functional Recovery in patients with Stroke- A Pilot Study

ABSTRACT Background: Impaired trunk stability and sitting balance after stroke causes problems with gait, balance, and activities of daily living of the individual. TIS and SBS are scales used for the assessment of trunk impairment and sitting balance, respectively. Patients’ expectations in terms of functional independence at the acute stage need to be answered by a healthcare professional for which a robust tool to predict the same is required. Therefore, this study is aimed at comparing the Trunk Impairment Scale and the Sitting Balance Scale in predicting functional outcome in patients of stroke. Methods: It is a pilot study conducted as an observational analytical study done in Neurophysiotherapy OPD, VPMH. A total of 10 stroke patients were included in the study in the age group of 30-65 years with impaired sitting balance. The clinical assessment items taken were taken at baseline, after 1 week, and after 4 weeks. Trunk control was assessed using the Trunk Impairment Scale (TIS), and the sitting balance was assessed using the Sitting Balance Scale (SBS). Motor function of stroke patients was assessed using the Stroke Impairment Assessment Set (SIAS). Functional independence was measured using the Functional Independence Measure (FIM), and dynamic balance and mobility by the Timed Up and Go (TUG) test and ICF Codes for assessing sitting and gait. Results: The correlations between TIS and SBS with TUG, FIM, SIAS & ICF codes for Sitting and Gait shows TIS was significantly better correlated with TUG (at baseline r=0.57,after 1 week r=0.59), FIM (at baseline r=0.90, after 1 week r=0.87), SIAS (after 1 week r=0.87, after 4 weeks= r=0.69), ICF Codes for Sitting d4153 ( after 4 weeks r=-0.35), d413 ( after 4 weeks r=-0.35), d4200 (at baseline r= -0.85, after 4 weeks r= -0.74), ICF Codes for Gait d455( after 4 weeks r= -0.86), d460 (at baseline, after 4 weeks r= -0.84), d465( after 4 weeks r= -0.86) Discussion: TIS is a better predictor of functional recovery than SBS after assessing at 4 weeks as the components are challenging to perform in the acute stage but they can be successfully assessed in the later stages and have a significant impact on activities of daily living (ADLs) whereas most components of SBS involve the use of upper extremity, hence it may not predict trunk control more accurately. Conclusion: This study concludes that TIS is a better predictor of functional recovery than SBS after assessing at 4 weeks from baseline assessment. Keywords: Trunk Impairment, Sitting Balance, Stroke, Functional Ability