title: A review on assessment and treatment of the trunk in stroke: A need or luxury.
abstract: Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross-sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.
authors.affiliation: Department of Physiotherapy, Manipal College of Allied Health Sciences, Manipal Hospital, Bangalore 560017, Karnataka, India.
authors.forename: Suruliraj
authors.initials: S
authors.lastname: Karthikbabu
authors.affiliation: Department of Medicine, Kasturba Medical College, Manipal University, Mangalore 575003, Karnataka, India.
authors.forename: Mahabala
authors.initials: M
authors.lastname: Chakrapani
authors.affiliation: Doctoral Advisory Committee, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Sailakshmi
authors.initials: S
authors.lastname: Ganeshan
authors.affiliation: Department of Neurology, Kasturba Medical College, Manipal University, Mangalore 575003, Karnataka, India.
authors.forename: Kedambadi C
authors.initials: KC
authors.lastname: Rakshith
authors.affiliation: Department of Physiotherapy, Manipal College of Allied Health Sciences, Manipal Hospital, Bangalore 560017, Karnataka, India.
authors.forename: Syed
authors.initials: S
authors.lastname: Nafeez
authors.affiliation: Department of Physiotherapy, Manipal College of Allied Health Sciences, Manipal Hospital, Bangalore 560017, Karnataka, India.
authors.forename: Venkatesan
authors.initials: V
authors.lastname: Prem
keywords: balance; electromyography; function; hemiplegia; review; strength; stroke; trunk control; trunk impairment scale; trunk muscle activity