Trunk control
Trunk Control Test
The Trunk Control Test scores four items — rolling to each side, sitting up from lying and balancing in sitting — out of 100. Trunk control measured early after a stroke helps predict whether a patient will later walk, at a stage when most other measures cannot yet be used.
Why it is used early
In the first days after a stroke most measures cannot be administered at all — the patient cannot stand. The TCT can, and it carries real predictive information at exactly the point when families are asking whether walking will return.
Its ceiling is reached quickly. Once sitting balance is achieved it stops discriminating, and we move to a balance or walking measure.
Key facts
| Abbreviation | TCT |
|---|---|
| Number of items | 4 |
| Score range | 0–100 |
| Time to administer | Under 5 minutes |
| Training required | No |
| Cost | Free |
| Equipment | Examination couch or bed |
| Domains | Trunk control · Balance |
| ICF domain | Activity |
| Age range | Adult |
| Populations | Stroke · Traumatic brain injury |
| Languages | Universal |
Psychometrics by population
The same instrument behaves differently in different conditions. A cut-off established in older adults does not transfer to Parkinson's disease, and a minimal detectable change from one study does not apply to another population.
| Population | Cut-off | MDC / MCID | Reliability | Validity |
|---|---|---|---|---|
| StrokeMarked ceiling effect once sitting balance is achieved | — | — | Good inter-rater reliability | Early score has predictive value for eventual walking ability (Collin and Wade 1990) |
Things to be careful about
- Very quick but coarse; the ceiling is reached early in recovery
- Best used in the first weeks, then replaced by a balance or walking measure
Frequently asked questions
Why is the trunk tested before walking is even possible?
Because in the first days after a stroke most measures cannot be administered at all — the patient cannot stand. The Trunk Control Test can be, and it carries real predictive information at exactly the point when families are asking whether walking will return. It scores four items: rolling to each side, sitting up from lying, and balancing in sitting.
What does an early score predict?
Trunk control measured early after a stroke has predictive value for whether a patient will eventually walk 1. It is a probability, not a promise — but it is among the earliest honest signals available.
Why did the team stop using it partway through my programme?
Because its ceiling is reached quickly. Once sitting balance is achieved the test stops discriminating — everyone who can sit unsupported scores at the top — so we move to a balance or walking measure that can still detect change. Being dropped from the assessment set is a sign of progress, not of the measure being abandoned.
Sources
- Collin C, Wade D. Assessing motor impairment after stroke: a pilot reliability study — Journal of Neurology, Neurosurgery and Psychiatry (1990)
Topic
Related instruments
- Rehabilitation outcomeFunctional Independence Measure (FIM)The FIM is an 18-item scale scoring how much assistance a person needs across thirteen motor and five cognitive tasks.
- Daily livingBarthel IndexThe Barthel Index is a ten-item scale of independence in daily activities, scored from 0 to 100 in five-point increments.
- Balance and fallsBerg Balance ScaleThe Berg Balance Scale assesses static and dynamic balance through fourteen everyday tasks, each scored 0 to 4, giving a total out of 56.
