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

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

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.

Study Overview

• Status: Completed
• Conditions: Cerebrovascular Accident; Balance Impairment
• Intervention / Treatment: Other: trunk exercise on unstable exercise; Other: Upper limb range of motion exercise

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 35
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• Taiwan
  • Tainan, Taiwan, 701
    • National Cheng Kung University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: trunk exercise on unstable surface; trunk exercise training in supine and sitting positions, with unstable surfaces	Other: trunk exercise on unstable exercise; 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.
Sham Comparator: upper limb range of motion exercise; upper limb range of motion exercise in sitting with back fully supported	Other: Upper limb range of motion exercise; Upper limb range of motion exercise with trunk fully supported

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: National Cheng Kung University
• Collaborators: Tainan Hospital, Ministry of Health and Welfare

Study record dates

Study Major Dates

• Study Start (Actual): August 9, 2018
• Primary Completion (Actual): October 6, 2019
• Study Completion (Actual): October 6, 2019

Study Registration Dates

• First Submitted: June 11, 2020
• First Submitted That Met QC Criteria: June 15, 2020
• First Posted (Actual): June 16, 2020

Study Record Updates

• Last Update Posted (Actual): June 16, 2020
• Last Update Submitted That Met QC Criteria: June 15, 2020
• Last Verified: June 1, 2020

More Information

Terms related to this study

• Keywords: stroke; balance; Trunk control; standing; Trunk exercise
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: B-ER-106-428

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No