The Association of Trunk Control and Postural Stability with Functional Ambulation in Stroke Patients: A Longitudinal Study

Background: Post-stroke ambulation is a crucial rehabilitation milestone, but it is often hindered by sensory impairments and postural instability. Comprehensive assessments of hip flexion strength, trunk control, and postural stability are essential for developing effective rehabilitation strategies. This study investigates the relationship between these factors with functional ambulation at one, six, and twelve weeks post-stroke, aiming to address gaps identified in previous researches. Methods: This longitudinal study was conducted at Hayatabad Medical Complex Peshawar from January to October 2023. A total of 102 patients with acute stroke were selected through non-probability convenience sampling. Patients were followed for twelve weeks. Cognitively stable patients with age >18 years and recent onset of ischemic or hemorrhagic stroke were included in this study. All the eligible patients were assessed using the Trunk Impairment Scale (TIS), the Functional Ambulatory Category (FAC), and the Postural Assessment Scale for Stroke (PASS). GraphPad Prism version (9.5) was utilized for data analysis. Results: Patients with minor strokes significantly improved TIS scores, increasing from 14.63 at week 1 to 19.43 by week 12 (p<0.01). The FAC and PASS showed substantial improvements from baseline to week 12 (p<0.01). Correlation analysis indicated a strong positive relationship at week 12 between FAC and TIS (r=0.72, p<0.05) and PASS (r=0.77, p<0.05), and a moderate correlation with hip flexor strength (r=0.55, p>0.05). Conclusion: Our findings reveal the critical connections between postural control, trunk performance, and functional ambulation during stroke recovery. The strong correlations between postural control, trunk performance and independent walking emphasize the importance of targeting trunk stability in early rehabilitation efforts to enhance patient independence. DOI: https://doi.org/10.59564/amrj/03.02/003