Trunk control assessment

Assessment of trunk control

1. Trunk Control Assessment Chetan Gaude ( OCCUPATIONAL THERAPIST)

2. Collin and Wade designed a quick and easily administered test of trunk control that is valid and reliable in clients with a diagnosis of CVA. It involves four timed tests: (1) rolling to the weak side (2) rolling to the sound side (3) moving from supine to sitting (4) sitting on the side of the bed with feet off the floor for 30 seconds Trunk Control Test Test battery to use with stroke patients and assess motor impairment, balance, coordination.

3. To accurately assess trunk control, the therapist must evaluate strength and control in the following muscle groups : Rectus abdominals External oblique Internal oblique Rectus abdominals Internal oblique Iliocostalis Longissimus QL Rectus abdominals, internal oblique,QL,iliocostalis , longissimus,intertransveralis External oblique Internal oblique Semispinalis Multifidus rotator

4. TRUNK FLEXORS The examiner asks the client to sit upright, To slowly move his or her shoulders behind the hips ( eccentric control ), and to hold the end-range posture (isometric control) The client then is asked to move forward (concentric control) to resume the initial upright posture The examiner should observe for evidence of unilateral weakness, potential for falls, and symmetry of weight shift. A functional test for trunk flexor control is to observe the client move from supine to sitting.

5. ECCENTRIC CONTROL/ISOMETRIC CONTROL CONCENTRIC CONTROL

6. TRUNK EXTENSORS Assesses concentric trunk extensor control Evaluates eccentric trunk extensor control TEST -2 TEST - 1 TEST -3

7. upright posture -The pelvis is stationary, and the upper trunk laterally flexes toward the mat table . (eccentric contraction of Lt side & msl shortening of Rt side) - Return to the original test position (concentric control of the left side) assessment of trunk and pelvis lateral flexion, where movement is initiated from the lower trunk and pelvis. LATERAL FLEXORS

8. - client sits upright and the pelvis is in a neutral, stable position. - The client reaches with his or her right arm, across the body, in the direction of the floor. Assessment of concurrent flexion and rotation. The motion tests concentric control of the obliques and the back extensors (particularly the thoracic region). Both sides need to be tested. TRUNK ROTATION Primary muscles responsible for rotation are the obliques . 3 MOTOR PATTERN

9. 2. Trunk extension with rotation. The upper trunk remains stable, and the lower trunk and pelvis move forward on one side (i.e., shifting forward). 3. Supine position -The client initiates a “segmental roll by lifting the shoulders from the support surface and toward the opposite side of the body. This pattern is controlled by a concentric contraction of the abdominals ( obliques )

10. Trunk control test as an early predictor of stroke rehabilitation outcome. Franchignoni FP 1 ,  Tesio L ,  Ricupero C ,  Martino MT . BACKGROUND AND PURPOSE: AIM : To investigate the construct and predictive validity of the Trunk Control Test (TCT) in postacute stroke patients by comparing TCT scores at admission and discharge with the Functional Independence Measure (FIM) scores. METHODS: Forty-nine patients participated in the study. The TCT examines four movements: rolling from a supine position to the weak side (T1) and to the strong side (T2), sitting up from a lying-down position (T3), and sitting balance (T4). The FIM is an 18-item scale (13 motor [ motFIM ] and 5 cognitive [ cognFIM ]) used to determine the level of dependence of patients in daily life.

11. RESULTS: Thirty-six patients (73%) increased their TCT overall score at discharge. The TCT item-total correlations were high, both at admission and discharge (P < .0001). The individual TCT items were intercorrelated . Furthermore, the homogeneity of the TCT was confirmed by a high Cronbach's index. High correlations were found between admission and discharge scores in the different tests (TCT, FIM, and motFIM ; P < .0001) and between TCT at admission and FIM (P < .0001) and motFIM (P < .0001) at admission. TCT at admission alone explained 71% of the variance in motFIM at discharge.

12. CONCLUSIONS: The TCT showed a good sensitivity to change in assessing recovery of stroke patients . The high item-total correlation and Cronbach's alpha value of the TCT suggest that there is one homogeneous construct underlying the item list. The TCT construct validity was confirmed by the correlation between this test and the FIM scores. TCT at admission predicted motFIM at discharge even better than motFIM at admission alone. Possibly, the TCT captures basic motor skills that foreshadow the recovery of more complex behavioral skills described by the FIM.

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