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The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis

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  • Kumar Gular

    (Division of Physical Medicine and Rehabilitation, Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar 608 002, India
    Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61471, Saudi Arabia)

  • Viswanathan Sivasubramanian

    (Division of Physical Medicine and Rehabilitation, Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar 608 002, India)

  • Ravi Shankar Reddy

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61471, Saudi Arabia)

  • Jaya Shanker Tedla

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61471, Saudi Arabia)

  • Snehil Dixit

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61471, Saudi Arabia)

Abstract

Background: The trunk acts as proximal support with which limbs execute smooth and purposeful movement. Furthermore, as upper extremity functions are an integral component of daily living activities, exploring the association between trunk and upper extremity recovery will guide therapists in developing appropriate rehabilitation goals and interventions. The objectives of this study were to (1) assess the association between trunk and upper extremity recovery in the subacute stroke population and (2) assess the effect of trunk control on upper extremity impairment and function with age, gender, and duration of stroke as mediators using mediation analysis in subacute stroke individuals. Methods: This cross-sectional study included 54 subacute stroke participants with a mean age of 58.37 ± 6.11 years. The trunk impairment scale (TIS) assessed the trunk’s stability, mobility, and coordination. The level of upper extremity impairment was evaluated using the Fugl-Meyer Assessment scale (FMA). The quality and quantity of upper limb motor functions were measured using the Wolf motor function test (WMFT). Results: The TIS exhibited moderate positive correlations with the FMA-UE, WMFT-time scale (TS), and WMFT-functional ability scale (FAS) at p < 0.001. The mediation analysis reported a profound mediation effect of post-stroke duration on the association of trunk and upper limb recovery. Conclusions: The study results substantiated that trunk control significantly correlates with upper limb impairment and the quality and quantity of its use in the subacute stroke population. Post-stroke duration proved to mediate the association between trunk and upper limb recovery. Therefore, the assessment and intervention of trunk and upper extremity motor control considering the post-stroke duration is vital and should be incorporated in stroke rehabilitation aiming at functional independence.

Suggested Citation

  • Kumar Gular & Viswanathan Sivasubramanian & Ravi Shankar Reddy & Jaya Shanker Tedla & Snehil Dixit, 2022. "The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis," IJERPH, MDPI, vol. 19(23), pages 1-12, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15644-:d:983369
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    References listed on IDEAS

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    1. Adrien Guilloteau & Christine Binquet & Abderrahmane Bourredjem & Isabelle Fournel & Marie Laure Lalanne-Mistrih & Mathieu Nacher & Devi Rochemont & André Cabie & Emmanuelle Mimeau & Caroline Mislin-T, 2020. "Social deprivation among socio-economic contrasted french areas: Using item response theory analysis to assess differential item functioning of the EPICES questionnaire in stroke patients," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-17, April.
    2. Ravi Shankar Reddy & Kumar Gular & Snehil Dixit & Praveen Kumar Kandakurti & Jaya Shanker Tedla & Ajay Prashad Gautam & Devika Rani Sangadala, 2022. "Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients—A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(19), pages 1-16, October.
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