title: Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients.
abstract: OBJECTIVE
  Prediction of activities of daily living (ADL) functions at an early stage after a stroke is critical because it enables clinicians to set treatment programs and goals. The objective of this study was to assess the relationship between trunk control at an early stage and comprehensive ADL function (as assessed by combining basic ADL and instrumental ADL [IADL]) in patients at 6 months after stroke.
  
  
  METHODS
  A total of 169 stroke patients participated in this prospective study. Trunk control was measured with the use of the trunk control items of the Postural Assessment Scale for Stroke Patients (PASS-TC). In addition to the PASS-TC score, age, sex, type of stroke, side of hemiparesis, urinary incontinence, limb paresis (measured by the Fugl-Meyer motor test), balance (measured by the Fugl-Meyer balance test), and basic ADL (measured by the Barthel Index) were also selected as predictor variables. These variables were assessed at 14 days after stroke or earlier. The Barthel Index and Frenchay Activities Index (measuring IADL) were administered at 6 months after stroke. The sum of the standardized Barthel Index and standardized Frenchay Activities Index scores was used to assess comprehensive ADL function.
  
  
  RESULTS
  Multivariable stepwise linear regression analysis showed that PASS-TC score, age, Fugl-Meyer motor test score, and Barthel Index score (listed by the order of forward selection) were the strongest predictors of comprehensive ADL function. These results were internally validated with the use of the bootstrap resampling technique. The PASS-TC score alone accounted for 45% of the variance in predicting comprehensive ADL function. Results also indicated that the PASS-TC score had slightly more power in predicting comprehensive ADL function than either the Fugl-Meyer motor test score or Barthel Index score.
  
  
  CONCLUSIONS
  The findings of this study provide strong evidence of the predictive value of trunk control on comprehensive ADL function in stroke patients. The results imply that early assessment and management of trunk control after stroke should be emphasized.
authors.affiliation: School of Occupational Therapy, College of Medicine, National Taiwan University, Republic of China. mike26@ha.mc.ntu.edu.tw
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Hsieh
authors.forename: Ching-Fan
authors.initials: CF
authors.lastname: Sheu
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Hsueh
authors.forename: Chun-Hou
authors.initials: CH
authors.lastname: Wang
mesh_terms: D000005:Abdomen / Q000294:innervation / Q000503:physiopathology; D000203:Activities of Daily Living; D000368:Aged; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D011187:Posture; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013909:Thorax / Q000294:innervation / Q000503:physiopathology; D013997:Time Factors