Clinical Bottom Line
Karen Kott, PT, PhD
Old Dominion University School of Physical Therapy, Norfolk, Virginia
Sharon Held, PT, DPT, MS, PCS
Department of Physical Therapy, Daemen College, Amherst, New York and Pediatric and Adult Habilitation and Rehabilitation, SportFocus Physical Therapy, Orchard Park, New York
“How could I apply this information?”
This study provides information on a systematic method to assess distinct levels of trunk control for sitting. It provides a clear, concise approach for examination of body function to distinguish possible impairments in separate levels of the trunk including head, thoracic, lumbar, and full trunk control. While current tools for testing sitting balance considered the trunk as a whole unit, this tool provides a way to assess the segmental areas of the spine for static, active, and reactive sitting. The tool also provides information about compensatory strategies when trunk control is compromised and may be used for the assessment of children with a range of abilities. After using this tool, the examiner would have a clearer idea of where and how to focus therapeutic intervention, including possible assistive technology for seating and standing, for improving trunk control and sitting balance, thereby addressing activity limitations and participation restrictions. If the examiner follows the instructions, intrarater reliability should be excellent. The authors offer, in the appendices, the testing instructions and scoring with pictures and photographs for edification. The value of this tool is further noted in the high correlations with current tools used to assess balance control and function. Its use would enhance clinical assessment.
“What should I be mindful about in applying this information?”
The authors make note that the raters were trained but that clinicians who are diligent in following the instructions should be reliable without extensive training/practice. There is a need for 2 people while testing, 1 to provide nudges during testing. Simple equipment is needed to control the pelvis while testing and the optional video equipment for taping is recommended. It is also important to note that this is an assessment of body function only and that it would complement other measures of activity and participation. Finally, at this time, further testing is needed to determine whether this test is sensitive to change.