Quantifies disability after stroke; also validated in Parkinson disease.
Why Use
Provides a structured assessment of trunk stability, balance, and coordination in sitting. Offers objective feedback on progress, which can help motivate patients and guide rehab interventions.
When to Use
Use in patients with neurological conditions (e.g., sub-acute or chronic stroke, Parkinson disease) affecting trunk control. Can be employed in both inpatient and outpatient rehabilitation settings to guide care planning.
Formula
Addition of the selected points: Static sitting balance # Item Finding Points 1 Patient maintains starting position without support for 10 seconds No 0, and total TIS score = 0 Yes +2 2 Therapist crosses unaffected leg over hemiplegic leg Falls or can’t maintain sitting position for 10 seconds without arm support. 0 Maintains sitting position for 10 seconds. +2 3 Patient crosses unaffected leg over the hemiplegic leg Falls 0 Can’t cross legs without arm support +1 Crosses legs but displaces trunk >10 cm backwards or assists crossing with hand +2 Crosses legs without trunk displacement or assistance +3 Dynamic sitting balance # Item Finding Points 1 Patient touches bed or table with hemiplegic elbow (shortens hemiplegic side and lengthens unaffected side) and returns to starting position Falls, needs support from upper extremity, or elbow does not touch the bed or table 0 (and items 2 & 3 score 0) Moves actively without help, elbow touches bed or table. +1 2 Repeat item 1 No (or opposite) shortening/lengthening 0 (and item 3 scores 0) Appropriate shortening/lengthening +1 3 Repeat item 1 Compensation (with upper extremity, hips, knees, or feet) 0 Moves without compensation +1 4 Patient touches the bed or table with unaffected elbow (shortens unaffected side and lengthens hemiplegic side) and returns to starting position Falls, needs support from upper extremity, or elbow doesn’t touch the bed or table 0 (and items 5 & 6 score 0) Moves actively without help, elbow touches bed or table +1 5 Repeat item 4 No (or opposite) shortening/lengthening 0 (and item 6 scores 0) Appropriate shortening/lengthening +1 6 Repeat item 4 Compensation (with upper extremity, hips, knees, or feet) 0 Moves without compensation +1 7 Lifts pelvis from bed or table at hemiplegic side (shortens hemiplegic side and lengthens unaffected side) and returns to starting position No (or opposite) shortening/lengthening 0 (and item 8 scores 0) Appropriate shortening/lengthening +1 8 Repeat item 7 Compensation (with upper extremity or foot) 0 Moves without compensation +1 9 Lifts pelvis from bed or table at unaffected side (shortens unaffected side and lengthens hemiplegic side) and returns to starting position No (or opposite) shortening/lengthening 0 (and item 10 scores 0) Appropriate shortening/lengthening +1 10 Repeat item 9 Compensation (with upper extremity or foot) 0 Moves without compensation +1 Coordination # Item Finding Points 1 Rotates upper trunk 6x (each shoulder moved forward 3x), hemiplegic side must move first, head fixated in starting position Hemiplegic side not moved 3x 0 (and item 2 scores 0) Asymmetrical rotation +1 Symmetrical rotation +2 2 Repeat item 1 within 6 seconds Asymmetrical rotation 0 Symmetrical rotation +1 3 Rotate lower trunk 6x (each knee moved forward 3x), hemiplegic side must move first, upper trunk fixated in starting position Hemiplegic side not moved 3x 0 (and item 4 scores 0) Asymmetrical rotation +1 Symmetrical rotation +2 4 Repeat item 3 within 6 seconds Asymmetrical rotation 0 Symmetrical rotation +1
Pearls / Pitfalls
Proper patient positioning and standardization of the test environment are crucial for accuracy. Patients must be able to follow basic commands. Note that the static subscale suffers from a ceiling effect and was removed in the 2.0 version ( Verheyden et al., 2010 ).
Advice
Combine these results with other functional measures (e.g., gait assessments, functional independence scales) for a more comprehensive view of recovery. Focus interventions on identified areas of deficit (e.g., trunk coordination, static balance, dynamic control). Use results to track progress over time and update rehabilitation goals as patients improve.