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:
- The highest segmental level at which intervention must be targeted.[1]
- 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. There has been no maximum age given to which this test can be administered, although once an individual has gained full active trunk control, the administration of the SATCo becomes difficult to perform. This owing to the fact that children with full trunk control are often difficult to contain on the assessment bench. [5]
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 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 |
| Full trunk | No support |
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]
Both inter-rater and intra-rater reliability are good With a study done with both term and preterm (age corrected) infants between 4 to 9 months, the interclass correlation (ICC) scored ≥ 0.8 .[5]
Moderate to good correlation was also found when comparing the SATCo against other motor assessments.[5]
Validity[edit | edit source]
Construct validity seems dependent on age and postural demands. For example, with young infants below the age of 8 months, the SATCo is not able to differentiate between preterm and term infants. The hypothesis here is that before 8 months both groups of infants have similar postural demands, being primarily reclined. It is further recommended that studies are performed with a greater sample size and over longer follow-up to verify this hypothesis.[5]
Responsiveness[edit | edit source]
Good responsiveness was demonstrated in SATCo testing of infants between 4 and 9 months.[5]
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]
- ↑ 1.0 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.
- ↑ 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).
- ↑ 3.0 3.1 OPTIMI Targeted Training. History of Targeted Training. Availilable from: https://optimi.org.uk/about-us/ (accessed: 26 April 2023).
- ↑ Leckley. SATCo Segmental Assessment of Trunk Control. Lisburn: Leckley.com
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 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.
