Clinical Tools to Measure Trunk Performance After Stroke: a Systematic Review of the Literature

Objective: To give a systematic review of clinical measurement scales used to assess trunk performance after stroke.

Data Sources: The databases CINAHL, Cochrane, Pedro and PubMed were searched with the terms 'sitting balance' plus 'stroke' and 'trunk' plus 'stroke' mentioned in the title or abstract. Databases were searched from inception to January 2006.

Review Methods: All articles were selected which reported or included a clinical measure of trunk performance used in an adult stroke population. Reference lists were searched as secondary sources of articles.

Results: A total of 458 articles resulted from the database search. Thirty-two articles were eligible for inclusion. Earlier studies mentioned ordinal single items or a combination of items which are part of a larger scale used to assess sitting balance as a derived measure of trunk performance. Three clinical tools were available which specifically evaluated trunk performance after stroke; the Trunk Control Test and two Trunk Impairment Scales.

Conclusion: Ordinal single items or subscales of existing larger scales lack a systematic evaluation of psychometric characteristics. Both Trunk Impairment Scales have been extensively examined. A comparative study assessing psychometric properties of the Trunk Control Test and two Trunk Impairment Scales could determine which should be the measure of choice when assessing trunk performance after stroke.