Investigation of the relationship between trunk balance and trunk position sense, wheelchair skills and functional independence in individuals with thoracic spinal cord injury

Spinal cord injuries (SCI) are serious neurological disorders that cause loss of motor, sensory, and autonomic functions, significantly limiting individuals' ability to perform daily living activities. The aim of this study is to investigate the relationship between trunk balance, trunk position sense, wheelchair skills, and functional independence in individuals with thoracic level spinal cord injury. The study was conducted with 32 individuals with thoracic SCI who were followed in the Physiotherapy and Rehabilitation Clinic of Afyonkarahisar Health Sciences University. The assessments included the Modified Functional Reach Test (mFRT), T-shirt Test, Trunk Control Test (TCT), Trunk Repositioning Error (TRE), Wheelchair Skills Test Questionnaire (WST-Q 5.0), and Spinal Cord Independence Measure III (SCIM III). Data analysis was performed using the SPSS 25.0 statistical software. The results revealed that individuals in the lower thoracic group showed significantly better performance in the mFRT, TCT, and WST-Q scores, as well as lower trunk repositioning errors (p<0.001). This group also demonstrated higher levels of functional independence assessed by the SCIM III compared to the upper thoracic group. Correlation analyses indicated significant positive relationships between trunk balance and position sense with both wheelchair skills and functional independence (p<0.01). This study demonstrates that trunk balance and position sense play a crucial role in enhancing wheelchair skills and functional independence in individuals with thoracic SCI. The findings suggest that targeting trunk control and proprioception during rehabilitation may be critical in improving clinical outcomes in this population.