What is the distribution of trunk impairments and its relationship with disability level in individuals with multiple sclerosis?

Abstract

Background: Trunk control is essential for movement, balance and walking and is ignored in the regular medical follow-up. Objective: First, to describe the distribution of trunk impairments in the full range of disability levels in individuals with MS. Second, to identify the relationship between trunk control, measured by the Trunk Impairment Scale (TIS 2.0.), and general disability measured by the Expanded Disability Status Scale (EDSS). Methods: 154 individuals with MS were included (mean age 53.6; SD 11.06), EDSS ranging from 1.0-8.5 (mean 4.47; SD 2.55). The relationship between EDSS and TIS 2.0. was calculated by Spearman correlation coefficient for the total sample and subgroups, EDSS <= 4 versus EDSS >= 4.5. Results: Trunk impairments were detected throughout the full range of disability, including individuals with low disability. Pelvic elevation and lower trunk rotation appeared most difficult to perform. In the total sample, a moderate correlation was found (rho= -0.608**) between disability (EDSS) and trunk performance (TIS 2.0.). Sub-analyses revealed a poor correlation (rho= -0.193) for the EDSS <= 4 subgroup and a strong correlation for the EDSS >= 4.5 subgroup (rho= -0.712**). Conclusion: The results advocate for including trunk assessment already at early disease stages of MS, particularly of pelvic elevation and trunk rotation, and dedicated rehabilitation strategies.