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Prognostic validity of trunk control scales for mobility in individuals with motor complete thoracic SCI: a prospective cohort study


Study Design

Prospective cohort study.


To investigate the sensitivity to change and prognostic validity of Trunk Control Test (TCT) and Thoracic-Lumbar Control Scale (TLC) in terms of mobility in persons with motor complete thoracic spinal cord injury (SCI).


Participants were recruited at an Italian SCI rehabilitation facility from October 2015 to January 2020.


Inclusion criteria were acute traumatic or non-traumatic event and T1-L1 neurological level. Trunk control and mobility were assessed at baseline, discharge, and at 6 and 18-month follow-ups. Mobility was measured using Spinal Cord Independence Measure III mobility subscale. Linear regression models were used to analyze changes in trunk control and mobility over time, and the relationship between these measures.


The 39 participants were predominantly male, with a mean age of 38 years. Trunk control improved during rehabilitation, at 6-month follow-up, and remained stable thereafter, according to TCT and TLC scales. A higher baseline TCT score was associated with improvements in mobility at discharge and at follow-ups. Baseline TLC score and its change during rehabilitation were unrelated with changes in mobility.


Results suggest that the TCT and TLC scales are useful to capture changes in trunk control during the acute and subacute phases. Improvements in functional mobility are however associated with TCT score only, suggesting the potential of this test as a useful prognostic indicator. Further research with larger sample sizes is warranted to determine whether these findings are consistent across neurological level strata.

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Fig. 1: Change over time in SCIM III mobility, TCT and TLC scores.
Fig. 2: Change over time in SCIM III mobility, TCT and TLC scores by neurological level group.

Data availability

The dataset generated and analyzed during the current study is available from the corresponding author on reasonable request.


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We wish to thank Dr. Jessica Cambiuzzi and Dr. Francesco Coschignano for their support in data acquisition, and Dr. Tiziana Giovannini for her support in designing the study protocol. Elisa Maietti was a brilliant statistician and an unforgettable joyful, radiant, generous and supportive colleague. This paper is dedicated to her memory.


No research grant was received for this study.

Author information

Authors and Affiliations



PP was responsible for designing the study protocol, conducting the study, screening potentially eligible patients, and writing the first draft of the manuscript. MM was responsible for conducting the study, screening potentially eligible patients, and interpreting results. IB provided feedback on the manuscript, and was responsible for submitting the study to the ethics committee. CK was responsible for supervising the research group and contributed to the paper writing. SN revised the manuscript for important intellectual content. EM performed the data analysis and contributed to interpreting the results and writing the draft. All authors approved the final version of the paper.

Corresponding author

Correspondence to Ilaria Baroncini.

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Competing interests

The authors declare no competing interests.

Informed consent

All participants provided written, informed consent and anonymity was maintained throughout the research process.

Ethical approval

Ethical approval (ethics committee code 15013, 25/06/2015) was granted by the local ethics committee (Comitato Etico Interaziendale Bologna-Imola).

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Paglierani, P., Marani, M., Maietti, E. et al. Prognostic validity of trunk control scales for mobility in individuals with motor complete thoracic SCI: a prospective cohort study. Spinal Cord 61, 529–535 (2023).

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