Functional decline after prolonged bed rest following acute illness in elderly patients: is trunk control test (TCT) a predictor of recovering ambulation?

Authors wanted to assess the predictive value of the trunk control test (TCT) on recovering ambulation in elderly patients who have developed walking disability. The study design was a prospective study performed in a hospital-based intermediate-care unit. Twenty-one patients (mean age 78.5+/-6.7 years) were investigated, who had developed walking disability after prolonged bed rest for an acute condition. A comprehensive geriatric assessment with functional status evaluation, based on the activities of daily living (ADL) (expressed as Barthel index=BI), and instrumental activities of daily living (IADL) (expressed as Lawton index=LI), cognitive function (Mini-Mental State Examination-Folstein=MMSE), depression (Geriatric Depression Scale=GDS) and comorbidity (Charlson comorbidity index=CCI) was performed within 72h after admission. A specialist in physical medicine and rehabilitation designed a rehabilitation program. TCT was performed in all patients before they started the program. The mean TCT score of the 21 patients was 52.7+/-22.9 (range: 0-100), while this score was 47.3+/-16.9 in the 15 patients who recovered ambulation, and 66.2+/-31.4 in the rest who did not (p=0.08). No statistically significant differences were observed either in subtotal scores of the TCT between groups. Furthermore, none of the TCT cutoff point was significantly associated with recovery. Cognitive function assessed by the MMSE was significantly better in patients who recovered, than in those who did not (23.4+/-3.9 vs. 17.8+/-5.2; p<0.02). Our conclusion is that TCT has not proved to be a predictor of recovering ambulation in elderly patients. In the present study, cognitive function was significantly associated with recovery after prolonged bed rest.