Effects of Trunk Exercise on Trunk Control and Balance in Persons With Stroke

Study Overview
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Brief Summary
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This study examined the effects of trunk exercise on unstable surfaces on trunk control and balance for persons in the sub-acute stage of stroke. The hypothesis was that, compared to upper limb exercises in well supported sitting position, this exercise would lead to better trunk control and sitting and standing balance. The results supported the hypothesis.

Detailed Description
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Inpatients in the sub-acute stage of stroke were randomly assigned to receive upper limb range of motion exercises in well supported sitting position or trunk exercises on unstable surfaces in supine and sitting, 30 min per session, 2 sessions per week for 6 weeks, in addition to their daily conventional stroke rehabilitation. Sensorimotor functions, including hand grip strength, plantar sensitivity, stroke rehabilitation assessment of movement and Fugl-Meyer lower extremity motor scale, and clinical outcome assessments, including Trunk Impairment Scale and 6-meter walk test, were conducted by a blinded assessor. Biomechanical outcome measures included center of pressure area while maintaining static posture and peak displacement while leaning forward, and the average speed of the unaffected arm raising (to represent the ability to provide a stable foundation for focal movement). These measures were taken in sitting without foot support, sitting with foot support and standing to reflect trunk control, sitting balance and standing balance, respectively.

Official Title
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Effects of Trunk Exercise on Unstable Surface on Trunk Control and Balance in Persons With Stroke

Conditions
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Cerebrovascular Accident, Balance Impairment

Intervention / Treatment
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* Other: trunk exercise on unstable exercise
* Other: Upper limb range of motion exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age: between 20-80 years old first time stroke could sit without back support at least 20 seconds could understand and follow experimental instructions Exclusion Criteria: medically unstable other neuromuscular/musculoskeletal problems that would affect balance

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: trunk exercise on unstable surface<br>trunk exercise training in supine and sitting positions, with unstable surfaces | Other: trunk exercise on unstable exercise<br>* Participants would receive exercises on unstable surface. Started from supine position, participants had abdominal drawer-in maneuver with soft foam under the pelvic. Lower trunk rotation, bridging and abdominal muscles isometric contraction exercises were also used in this exercise during supine position, with different unstable surfaces used. Including soft foam under the feet, then progressed to BOSU ball under the feet, then progressed to the a BOSU ball under the feet combined with pelvic on soft foam. During sitting, BOSU ball and Swiss ball were used as unstable surface. Pelvic anterior-posterior tilt, lateral tilting, rotation, lifting, and stepping with arm swing were used in this position.<br>|
| Sham Comparator: upper limb range of motion exercise<br>upper limb range of motion exercise in sitting with back fully supported | Other: Upper limb range of motion exercise<br>* Upper limb range of motion exercise with trunk fully supported<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Center of pressure | range of displacement (cm) | 6 weeks | 
| Angular velocity of the non-affected arm raising | mean velocity | 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trunk Impairment Scale | total score (0-23); higher scores mean better outcome | 6 weeks | 
| 6-meter walking tests | time (sec) to walk 6 meters | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, balance, Trunk exercise, Trunk control, standing