Pelvic alignment in standing, and its relationship with trunk control and motor recovery of lower limb after stroke

Background: The pelvis is not stable after stroke, and poor trunk recovery might be the foremost contributor to altered pelvic alignment in sitting, standing and during walking. Aim: To analyze the relationship between pelvic alignment in standing and trunk control after stroke, and also test how these correlations are related to Brunnstrom's lower limb motor recovery. Methods: In the present cross-sectional study, 116 ambulant patients after stroke were assessed for their pelvic tilt angles in standing and trunk control using a palpation meter (PALM device) and the Trunk Impairment Scale (TIS), respectively. The pelvic tilt values were correlated to TIS scores by the Pearson's correlation coefficient. Results: The mean age, post-stroke duration, and Brunnstrom's lower limb motor recovery of study participants were 55 (13) years, 14.2 (11.3) months and 3.75 (0.79), respectively. The present study reported more lateral pelvic tilt of 2.47° (1.78°) towards the most affected side and an anterior pelvic tilt of 4.4° (1.8°) bilaterally. The mean score of TIS was 10.4 (3). Pelvic tilt angles had a moderately inverse correlation with the total TIS score and coordination subscale of TIS (r-value from –0.44 to –0.54), but a low inverse relationship to the dynamic sitting balance subscale of TIS (–0.36 to –0.45). Also, the pelvic tilt had a high negative correlation with trunk control (r-value from –0.68 to –0.84) in lower limb motor recovery stage 5. Conclusion: Pelvic alignment when standing is not normal after stroke, and this is influenced by poor trunk control and impairment of the lower extremities. Assessment of the pelvis provides further insight into planning the appropriate rehabilitation strategies in stroke.