Impaired Upper Limb Motor Function in Post-Stroke Patients and Its Impact on Trunk Control and Mobility- a Cross-Sectional Study

Objective: To find the impact of impaired upper limb motor function on trunk control and mobility in chronic post-stroke survivors so that the upper limb function should be enhanced as a core component of rehabilitation. Methods: This analytical cross-sectional study was conducted from March 2021 to August 2021 at Rehabilitation Center for the Physically Disabled, Peshawar, Pakistan. A total of 166 chronic stroke patients in the age group of 35-70 years and greater than 6 months post-stroke were included. For the assessment of impaired upper extremity (UE), the Fugl-Meyer Assessment Upper Extremity (FMA-UE) scale was used and trunk control and mobility were checked through Functional Reach Test (FRT) and Timed Up and Go (TUG) test respectively. Results: Among 166 stroke survivors having upper extremity impairment, 109 (65.7%) participants' upper extremity was severely affected. Mobility levels measured through the TUG test were categorized and scored as a low risk of 22(13.3%), moderate 32(19.3%), high 72 (43.4%), and very high risk of falls of 40 (24%). Among 166 patients 147 (88.6%) have no trunk control which in turn resulted in 8 times greater fall risk in 65 (39.2%) participants. Thus upper limb impairment is significantly associated with impaired trunk control and mobility (P=0.001). Conclusion: This study found about 1/3 of stroke survivors have a risk of falling, 2/3 have upper extremity impairment, and 2/3 have no trunk control. This study shows a significant reduction in mobility level, balance, and posture balance in stroke survivors having upper extremity impairment. These findings suggest that stroke survivors with upper extremity impairment may use therapeutic intervention to minimize falls and enhance postural balance and trunk control.