Association between trunk control and chest expansion in individuals with acute and subacute stroke: Evidence from a tertiary care hospital in Sri Lanka

Background & Aim: Stroke survival is frequently associated with significant residual disability worldwide. Impairment of trunk control, an early and well-established predictor of functional recovery, is commonly observed in individuals following stroke and affects movements across all planes. In addition, post-stroke respiratory muscle weakness may further compromise trunk stability and postural control. Moreover, respiratory muscle strength is positively linked with chest expansion. Therefore, this study aims to explore the association between trunk control and chest expansion as a newly emerging area of interest, which will contribute to advancing post-stroke rehabilitation.
Methods: We conducted a descriptive cross-sectional study at the Neurology Physiotherapy Unit, National Hospital of Sri Lanka. Chest expansion (upper and lower) was measured with a measuring tape. Trunk control, static sitting balance, dynamic sitting balance and trunk coordination were assessed using the Trunk Impairment Scale (TIS). Pearson and Spearman correlation tests were used to identify associations of chest expansion with trunk control, static sitting balance, dynamic sitting balance, and trunk coordination.
Results: Out of 84 participants recruited, 65 were males and 19 were females. Mean age was 59.64 (SD=10.31) years. Mean post stroke duration was 53.55 (SD=30.82) days. Mean TIS score was 15.54 (SD=3.52), with mean upper chest expansion and lower chest expansion values of 2.54 (SD=0.85) cm and 3.01 (SD=1.17) cm, respectively. There were significant positive correlations of lower chest expansion with static balance (r=0.25, p=0.02), dynamic sitting balance (r=0.25, p=0.02), trunk coordination (r=0.41, p<0.0001) and trunk control (r=0.55, p<0.0001). However, upper chest expansion showed a significant correlation only with static sitting balance (r=0.28, p=0.01).
Conclusions & Recommendations: There is a significant positive correlation between trunk control and lower chest expansion in acute and sub-acute post-stroke individuals. This suggests that improving chest expansion may enhance trunk control. Therefore, incorporating chest expansion exercises in the early stages of stroke rehabilitation could be beneficial, and further research should explore their impact. An integrated approach may improve functional outcomes and quality of life of this population.