Evaluation of Seated Trunk Postural Control in Patients with Spinal Cord Injury: Systematic Review of Literature

Background: SCI patients have impairments of postural trunk control in sitting position. Aim: To compare the different evaluation scales of trunk postural balance in sitting position in patients with SCI, to elect the best EBM one. Methods: A systematic review of literature in accordance with PRISMA statement was conducted, using the PICO model for the clinical query. Articles were searched in: PubMed, Medline, Cochrane database, PEDro, EBS base index. RCTs/cohort studies concerning scale for the assessment of seated postural trunk control in patients with SCI were included. Methodological quality was evaluated using New Castle-Ottawa Scale. Results: Ten studies were selected for the final phase of the review. A total of 13 tools to evaluate postural trunk control in the sitting position emerged: 4 for chronic SCI, 8 for acute SCI and 1 for paediatric patients. No scale has been fully investigated in terms of reliability, validity, responsiveness or reproducibility. Discussion: None of the 13 rating scales can be defined as gold standard. TCT-SCI is valid and reliable for acute SCI. Furthermore, it is useful to predict independence and walking. The FIST-SCI is the most reliable scale for patients with chronic SCI, although it may present practical limits in home setting