Influence of Trunk Function on Assisted Gait and Independence in Patients With Acute Stroke

Background Achieving independent gait at discharge from an acute care hospital remains challenging, necessitating the identification of factors associated with different levels of gait assistance. Unlike previous studies, this study emphasizes the prognostic value of the Trunk Impairment Scale (TIS) when assessed within 48 h of stroke onset. Our findings highlight the predictive utility of early trunk function assessment in determining gait assistance levels at discharge and provide actionable insights for optimizing rehabilitation planning in acute care settings. Objective This study is aimed at comparing gait assistance levels at discharge among patients with acute stroke and examining the association between gait assistance and trunk function. Methods This prospective observational study included 115 stroke patients who were unable to achieve independent gait at discharge from an acute care hospital. Evaluations were conducted within 48 h of stroke onset and the day before discharge. Trunk function was assessed using the TIS, a practical bedside tool for evaluating core stability. Gait ability at discharge was classified as mild, moderate, or severe. Results Significant differences in TIS scores were observed between the mild and moderate assistance groups ( p < 0.05), mild and severe assistance groups ( p < 0.001), and moderate and severe assistance groups ( p < 0.01). The odds ratio (OR) for TIS scores was 1.53 (95% confidence interval CI: 1.06–2.20, p < 0.05) when comparing the mild and moderate assistance groups. For the moderate and severe assistance groups, the OR was 0.70 (95% CI: 0.53–0.92, p = 0.01). No significant associations were found for other variables. Conclusions TIS score was strongly associated with gait assistance level, underscoring their predictive value for discharge gait ability. Early TIS assessments facilitate accurate prognostication and support the development of individualized rehabilitation plans, potentially improving functional outcomes in acute care settings.