• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.379-386
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• 2021

Objective: The purpose of this study was to systematically review the trunk impairment scale that are used to assess the trunk control of stroke patients. Design: A systematic review Methods: Stroke subjects were categorized as acute, subacute, chronic. In this systematic review, the studies published between 2000 and 2020 were selected. A literature search using the keywords 'QUADAS', 'stroke', 'trunk impairment scale'. Data sources included RISS, GOOGLE Scholar and DBpia. We assessed the quality of assessment tools using Quality Assessment of Diagnostic Accuracy Studies tool. Results: We reviewed 18 studies. 7 of the 18 studies reported reliability results, 10 reported validity results. The QUADAS tool quality evaluation of 17 literatures extracted except for one randomized control test among 18 literatures showed a range of 3 to 13 points. 5 of the 18 studies are presented with the Cronbach alpha coefficient indicating reliability using internal consistency, all of which are more than 0.8. All studies that presented test-retest reliability, intra-rater reliability, and inter-rater reliability showed high agreement with an intra-class correlation coefficient of 0.75 or more. Conclusions: A systematic review of the study of the application of the trunk impairment scale for stroke patients will help provide criteria for future studies and application of the trunk impairment scale in clinical practice.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.2
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• pp.101-108
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• 2023

Purpose : To investigate effects of transcranial directed current stimulus (tDCS) combined with abdominal draw-in maneuver (ADIM) on balance ability and trunk impairment scale of chronic stroke patients. Methods : Twenty-six chronic stroke patients were recruited and twenty-four participated after excluding two patients who met the exclusion criteria. After screening tests, they were randomized through excel program into an experimental group (n = 12) to apply a tDCS combined with ADIM and a control group (n = 12) to apply a sham tDCS with ADIM. The intervention lasted three times a week for six weeks. To compare tDCS intervention effects, trunk impairment scale and balance ability were measured. Comparisons between experimental and control groups were statistically processed using an independent t-test and comparisons within groups were statistically processed using a paired t-test. Results : The experimental group showed significant increases of pre- and post-intervention medial lateral velocity, anterior posterior velocity and area of balance ability, and trunk impairment scale (p<.05). The control group showed significant increases in pre- and post-intervention medial lateral velocity of balance ability and trunk impairment scale (p< .05). The experimental group showed significant increases of medial lateral velocity of balance ability and trunk impairment scale compared to the control group (p<.05). Conclusion : Results of this study suggest that tDCS combined with ADIM for chronic stroke patients can be effective in improving medial lateral velocity of balance ability and trunk impairment scale. Thus, tDCS can be used as an effective treatment protocol for trunk rehabilitation of chronic stroke patients.

• Physical Therapy Korea
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• v.15 no.4
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• pp.87-96
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• 2008

The purpose of this study was to establish the reliability of the Trunk Impairment Scale (TIS) translated into Korea in patients with stroke. It also aims to score the quality of trunk movement and to be a tool for the treatment. The TIS consists of three subscales that static sitting balance, dynamic sitting balance and co-ordination. The TIS score ranges from a minimum of 0 to a maximum of 23. Twenty-five stroke patients (13 males, 12 females) were examined by two physiotherapists. Interrater and test-retest reliability were assessed. Kappa and weighted kappa values for the items of the trunk assessment of the TIS ranged from .67 to 1.00. Intraclass correlation coefficients for interrater and test-retest agreement were .95 and .97. Cronbach alpha coefficients for internal consistency range from .87 to .97. The TIS provide reliable assessments for the trunk and are valid scales for measuring trunk performance in patients with stroke. TIS can be used as a guideline for treatment and the assessment of quality of trunk activity.

• Physical Therapy Korea
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• v.17 no.2
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• pp.33-42
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• 2010

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity ($FM-U{\cdot}L/E$), The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (${\beta}=.420{\sim}.832$) had slightly more power in predicting trunk control than the $FM-U{\cdot}L/E$. TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study 치early indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

• PNF and Movement
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• v.19 no.1
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• pp.67-77
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• 2021

Purpose: The purpose of the study was to identify the effects of proprioceptive neuromuscular facilitation (PNF) training and robot rehabilitation training on trunk stability and standing balance in individuals with chronic stroke. Methods: There were 30 patients with chronic stroke, divided into two groups: 15 subjects who received PNF and robot training (the experimental group) and 15 subjects who received standard conservative training (the control group), that participated. The experimental group received treatment for 60 min: 30 min of conventional physical therapy, 15 min of PNF training, and 15 min of robot training. The control group received conventional physical therapy for 60 min. Trunk stabilization (trunk impairment scale) and standing balance (center of pressure, limit of stability, modified functional reach test, and Berg balance scale) were measured before and after intervention. Results: Within each group, both the experimental and control groups significantly improved after the intervention in all tests; however, the experimental group showed greater improvement in scores on the trunk impairment scale, the center of pressure, the limit of stability, the modified functional reach test, and the Berg balance scale. Conclusion: The study verified that PNF training and robot training had a positive influence on trunk stability and standing balance indices in patients with chronic stroke.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.25-33
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• 2017

PURPOSE: The initiation of the trunk muscles in stroke patients is delayed because the muscles involved in reach arm are activated earlier than the trunk muscles. The objective of this study was to examine the effects of mobility, balance, and trunk control ability through selective trunk exercise (STE) in patients with chronic stroke. METHODS: A randomized pre-test and post-test control group design was initially used, with subjects randomly assigned to the STE group (n=15) and a control group (n=14). All groups underwent physical therapy based on the neuro-developmental therapy (NDT) for 30 minutes a day, five times per week for four weeks. Additionally, the STE group did the trunk exercise for 30 minutes a day, three times per week for four weeks. The timed up and go test (TUG), Berg balance scale (BBS), and trunk impairment scale (TIS) were used for assessment. RESULTS: The scores of the TUG, BBS, dynamic sitting balance subscale, and coordination subscale of TIS improved significantly in both groups but the improvement was more pronounced in the STE group (p<.05). This study showed a large effect on the scores of the TIS coordination subscale (d=.93) (p<.05), TIS dynamic balance subscale (d=.81) (p<.05), TUG (d=.75) (p<.05), and BBS (d=.73) (p<.05). CONCLUSION: The combined STE and NDT program showed improvements in measures of mobility, balance, and trunk control in chronic stroke patients. These results suggest that STE should be considered to be included in the treatment program for patients with chronic stroke.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2323-2330
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• 2021

Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupII. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn't show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

• PNF and Movement
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• v.12 no.4
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• pp.249-258
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• 2014

Purpose: This study examines deficits in upper-extremity function and trunk control ability on the osmotic demyelination syndrome of a patient with Hyponatremia and Hypokalemia. Using a proprioceptive neuromuscular facilitation program, this case report aims to describe the effects of trunk stability exercises on trunk control ability, hand function, and daily living activities as well as its effects on the osmotic demyelination syndrome of a patient with Hyponatremia and Hypokalemia. Methods: The patient is a 47-year-old woman with osmotic demyelination syndrome as well as trunk and upper extremity impairment. She participated in this training intervention for four weeks. Results: The patient demonstrated improvements in trunk control ability, hand function, and performance of ADL. The following outcomes were measured before and after the training program: trunk impairment scale, hand power, Jebsen-Taylor hand function test, the Chedoke arm and hand inventory, and the modified Barthel index. Conclusion: The results suggest that trunk stability exercises in the form of a proprioceptive neuromuscular facilitation program in Hyponatremia and Hypokalemia patients may increase trunk control ability, increase hand function, and improve ADL.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.171-181
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• 2020

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

• PNF and Movement
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• v.13 no.4
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• pp.203-213
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• 2015

Purpose: Deficits in lower-extremity function and trunk control ability have a negative impact on individuals with hemiplegia. This case report aimed to describe the effect of trunk stability exercises using proprioceptive neuromuscular facilitation (PNF) on trunk control ability, balance, and gait in a patient with hemiplegia. Methods: A 77-year-old man with hemiplegia and trunk and lower extremity impairment participated in this four-week training intervention. Results: The patient demonstrated improvements in trunk control ability, balance, and gait performance. Outcome measures (Fugl-Meyer Assessment Lower Extremity (FMA-LE), Trunk Control Test, Berg Balance Scale, Timed Up and Go test, 10 Meter Walk test) were measured before and after the training program. Conclusion: The results of this case suggest that a trunk stability exercise using a PNF program may improve trunk control ability, balance, and gait in a patient with hemiplegia.