Impact of Trunk Function and Lower Limb Paralysis on Independence in Activities of Daily Living in Patients with Stroke

Stroke is a major global health issue, and many patients experience motor paralysis and sensory impairments that affect their independence in activities of daily living (ADL). Trunk and lower limb functions are crucial in post-stroke ADL independence. Although these two functions are closely related, few studies have evaluated them in combination, and the importance of assessment methods that consider their mutual relationship has not been thoroughly examined. In this study, we aimed to clarify the degree to which trunk function and lower limb paralysis impact ADL independence when evaluated individually versus in combination, through a hierarchical regression analysis, and to verify the significance of the combined assessment of both functions. This cross-sectional study included 51 patients with first-ever stroke and hemiplegia. Trunk function was assessed using the Trunk Impairment Scale, lower limb paralysis was evaluated using the Brunnstrom Recovery Stage for the lower extremities, and ADL independence was measured using the Functional Independence Measure. Hierarchical regression analysis was conducted to examine the impact of trunk and lower limb functions on ADL independence. Across two regression models, the assessment of trunk and lower limb function in combination significantly improved the accuracy in reflecting ADL independence compared with the assessment of each function individually. The findings suggest that a combined assessment of both trunk and lower limb functions is a valuable evaluation method in the rehabilitation of patients with stroke.