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Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: a systematic review.

BACKGROUND
Trunk control has been identified as an important early predictor of functional outcome after stroke but there is insufficient evidence that proximal stability of the trunk is a pre-requisite for sitting and standing balance, walking, and functional activities.


OBJECTIVE
We systematically reviewed the literature on trunk training exercises (TTE) in adult patients with stroke. To establish if TTE can improve trunk performance and sitting balance.


METHODS
CENTRAL, MEDLINE, EMBASE, CINAHL, PEDro, REHABDATA Database, Scielo, Scopus, Web of Science, Trip Database, and Epistemonikos were searched and reference lists screened to identify randomised controlled trials (RCTs) of trunk training exercises in stroke survivors. Two reviewers independently screened references, selected relevant studies, extracted data, and assessed trial quality. The primary outcomes were trunk performance and sitting balance. Due to the heterogeneity of included studies meta-analysis was not possible.


RESULTS
A total of 11 studies with 317 participants were analysed. Trunk training exercises showed a moderate evidence to improve trunk performance and dynamic sitting balance.


CONCLUSIONS
Trunk training exercises, performed with either stable or unstable surface, could be a good rehabilitation strategy and might help improving trunk performance and dynamic sitting balance after stroke.