Segmental Assessment of Trunk Control (SATCo)

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Objective[edit | edit source]

The objective of the Segmental Assessment of Trunk Control (SATCo) is to provide a detailed assessment of trunk control, identifying:

  1. The highest segmental level at which intervention must be targeted.[1]
  2. And the optimal level of support needed by the individual.[2] [3]

It is an assessment tool and outcome measure which provides a "close definition of the level at which trunk control difficulties present and leads to a 'level by level' treatment to the development of trunk control" (Butler et al, 2010). [1][4]

The development of the SATCo has been specifically designed as part of the Targeted Training (TT) approach. TT itself is a therapeutic strategy developed by Penny Butler and Richard Major to improve the functional abilities of children with problems of movement control through improving control of upright posture.[3]

Intended Population[edit | edit source]

SATCo has initially been developed for infants and children with neuromotor developmental impairments.[5]

Children as young as 4 months have been included in studies using the SATCo. and there has been no maximum age given to which this test can be given.

Method of Use[edit | edit source]

SATCo is performed in the clinical setting or at home.

It examines postural control in a sitting position by a gradual reduction of support and under three different conditions.

The three conditions are:

  • Static control - Maintaining a neutral vertical posture with no movement.
  • Active control - Maintaining a neutral vertical posture with voluntary head movements or arm movements.
  • Reactive control - A recovery of the neutral vertical posture after a disturbance of balance caused by a nudge.


The support is provided at six distinct levels, moving cephalo-caudally, starting at the shoulder girdle and ending without any support given.

These levels are:

Anatomical level Manual support
C7 Shoulders
T1-3 Axillae
T3-7 Inferior scapulae
T7-T11 Lower ribs
T12-L3 Below ribs
L4-S5 Pelvis

Basic set-up[edit | edit source]

The child wears only a nappy or shorts as the trunk need to be clearly observed.

A minimum of two testers are required:

  • One to support the trunk
  • Another to a) monitor the child's posture b)monitor the child's hand and arm position and c) provide nudges for the reactive component of SATCo.

Child's position:

  • Seated on a bench. Pelvis is stabilised by support system. Feet supported (age dependent).
  • Head is central with eyes looking forward. The chin is neither protracted or retracted.
  • Shoulder girdle is neither protracted nor retracted.
  • Hands and arms are free from contact with own body or any external support.
  • Spinal profile should be normal for age with no joints at end of range.
  • Pelvis in neutral.
  • Hip and knee angles both at 90°
  • Feet supported if age appropriate.

Important to remember: The head and body is to be kept in a neutral vertical posture both above and below manual support provided.

Reference
[edit | edit source]

Evidence[edit | edit source]

Reliability[edit | edit source]

Validity[edit | edit source]

Responsiveness[edit | edit source]

Miscellaneous[edit | edit source]

https://www.youtube.com/watch?v=jLzx1e2IQeQ accessed 22nd April

https://www.youtube.com/watch?v=jMS4C6eDg6Y

Links[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 Butler P, Saavedra MS, Sofranac MM, Jarvis MS, Woollacott M. Refinement, reliability and validity of the segmental assessment of trunk control (SATCo). Pediatric physical therapy: the official publication of the Section on Pediatrics of the American Physical Therapy Association. 2010;22(3):246.
  2. Vialu C. SeekFreeks. 2 Free Tests for Adaptive Equipment Selection and Implementation. Available from: https://www.seekfreaks.com/index.php/2019/07/25/2-free-tests-for-adaptive-equipment-selection-and-implementation/ (accessed: 25 April 2023).
  3. 3.0 3.1 OPTIMI Targeted Training. History of Targeted Training. Availilable from: https://optimi.org.uk/about-us/ (accessed: 26 April 2023).
  4. Leckley. SATCo Segmental Assessment of Trunk Control. Lisburn: Leckley.com
  5. Pin TW, Butler PB, Cheung HM, Shum SL. Segmental Assessment of Trunk Control in infants from 4 to 9 months of age-a psychometric study. BMC pediatrics. 2018 Dec;18:1-8.