Thoracolumbar Fascia Thickness in Chronic Stroke Patients

Primary outcomes

1. Ultrasonographic Assessment

   Time frame: Baseline

   In this study, ultrasonography will be used to assess the thickness of the thoracolumbar fascia in participants. Participants will be assessed in a comfortable prone position. A physical therapist trained in musculoskeletal ultrasonography will measure the thickness of the thoracolumbar fascia at standard anatomical landmarks. During measurements, care will be taken to ensure the probe is placed perpendicularly and steadily against the muscle tissue, and the images will be optimized and recorded to ensure accurate measurement of muscle thickness. Data obtained will be expressed in millimeters and recorded along with the participants' age, gender, and other demographic information.

2. Sit-and-Reach Test

   Time frame: Baseline

   This study will be used to assess the flexibility of participants' hamstrings and lumbar extensors. This test is a standardized assessment method that measures how far a person can reach in a seated position with their legs straight, typically using a flexibility box or tape measure. Participants will be asked to sit with their legs straight and lean forward, with their feet resting on the measuring box or wall, without bending their knees. They will be asked to touch their toes as far forward as possible. The farthest point they reach will be recorded in centimeters. The test will be repeated twice, and the best performance will be considered. The resulting values will be used in analyses as an indicator of participants' trunk and lower extremity flexibility levels.

3. Functional Reach Test

   Time frame: Baseline

   This test is a simple and reliable method for measuring static balance, measuring the maximum distance in centimeters a person can extend their arm forward while standing. The participant is asked to stand parallel to a wall, make a fist with their arm flexed 90 degrees at shoulder height, and reach forward as far as possible without losing their balance or lifting their feet off the ground. The distance between the initial toe position and the maximum reach position is recorded. The test will be repeated three times, and the best performances will be evaluated.

4. Timed up Go Test

   Time frame: Baseline

   The test assesses functional mobility and balance. The participant rises from a chair, walks 3 meters, turns, walks back to the chair, and sits down. The duration of this activity is recorded with a stopwatch. The test can be performed with the individual's usual assistive devices to ensure safety. Multiple attempts are usually required to ensure optimal performance.

5. Trunk Impairment Scale

   Time frame: Baseline

   This scale consists of three main sections: static sitting balance, dynamic sitting balance, and trunk coordination. The TIS, which contains 17 items in total, has a maximum score of 23, with higher scores indicating greater trunk control and mobility. The assessment will be conducted by a qualified physiotherapist in accordance with established standard procedures. The results obtained from the scale will be used in statistical analyses as an objective indicator of participants' trunk performance and will be an important data source for determining relationships with other functional parameters.

6. Functional Independence Measure

   Time frame: Baseline

   The test will be used to assess participants' levels of independence in activities of daily living and their care needs.Each item is scored from 1 (complete dependence) to 7 (complete independence), and the total score ranges from 18 to 126. Higher FIM scores indicate greater functional independence.