Translation, reliability, and validity of the trunk impairment scale in a Polish population after stroke.
Joanna Małecka, Magdalena Goliwąs, Katarzyna Adamczewska and 3 others
PMID 41804270WHAT IT FOUND
The Polish Trunk Impairment Scale is reliable for stroke patients with moderate-to-severe trunk issues, but it fails to distinguish those with mild impairment because 46% of participants hit the maximum score.
Use it to track progress in patients who struggle with sitting balance, not to assess those who are nearly recovered.
Key findings
01The scale showed excellent internal consistency and reliability, with test-retest and inter-rater agreement scores indicating high stability.
02Construct validity was moderate, with 6 out of 8 hypotheses confirmed, showing high correlations with lower limb motor function and moderate correlations with upper limb activity.
03A significant ceiling effect was present, affecting 46% of participants, meaning the scale did not effectively differentiate patients with minimal trunk impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only patients with hemiparesis, excluding those with hemiplegia or severe cognitive/speech deficits, so the results do not apply to those populations. Almost half of the participants (46%) scored at the ceiling of the scale, meaning the tool failed to distinguish between patients with mild trunk impairment and those with no impairment. The study was cross-sectional and did not test responsiveness, so we do not know if the scale is sensitive to change over time during rehabilitation. The sample was relatively small (80 participants) and from a single center, limiting generalizability. The high proportion of patients with good trunk control likely inflated the reliability estimates.
Declared interests
The paper does not list any funding sources or conflicts of interest.
The easy way to misread this
Do not assume the scale is equally useful for all stroke patients. Because 46% of the participants in this study scored at the maximum level, the scale is insensitive to mild trunk impairments. Using it on a patient who is already sitting well will likely result in a 'normal' score even if they have subtle deficits, leading you to underestimate their need for trunk-specific intervention.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →