Effects of Core Strengthening With Pelvic Proprioceptive Neuromuscular Facilitation on Trunk Control and Balance in Patients With Sub-acute Stroke

January 27, 2026 updated by: Lahore University of Biological and Applied Sciences
Purpose of this study was to investigate the effectiveness of core stabilization with pelvic proprioceptive neuromuscular facilitation on trunk control and balance which will be provided an evidence-based selection of the best possible intervention to improve trunk function and balance as compared to the trunk control exercises such as Rhythmic stabilization, Bridging, Side-Lying Trunk Lifts, Quadruped, Kneeling and modified plantigrade positioning, which one can provide the better balance and trunk control in sub-acute stroke patients.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Interventions FITT Principle Intervention was given for 60 min per session (30 + 30 mins for each group), including 3 sets with10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise (this FITT principle for core stabilization and trunk control exercises). For PNF technique each technique was applied for 3 sets of 2 min duration each with 30 sec between each set and 2 min rest after each technique.

Once a day, 5 times per week for 6 weeks for both groups. Groups There were two groups Groups 1 (interventional group) Groups 2 (control group) Groups 1 (interventional group) Participants who were included in this group got Pelvic Proprioceptive neuromuscular facilitation techniques + core strengthening group + Trunk control exercises (Conventional treatment).

Core stabilization exercises techniques Core activated by Bio Feedback apparatus and participants were given instructions to do trunk curls in crook lying position. Asked to lift their upper trunk slightly (15 degree) from the plinth. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.

Proprioceptive neuromuscular facilitation techniques The sequence was rhythmic initiation, slow reversal then agonistic reversals. each technique was applied for 3 sets of 2 min duration each with 30 sec between each set and 2 min rest after each technique. A stopwatch was used to measure the time.

Trunk control exercises Different trunk exercises were performed by the participants to develop trunk control and balance. Rhythmic stabilization, Side-Lying Trunk Lifts, Bridging, Quadruped, Kneeling and modified plantigrade positioning, are the trunk exercises which were used conventionally to develop trunk control. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.

Groups 2 (control group) Participants in group 2 received Core stabilization exercises + Conventional trunk control exercises (Rhythmic stabilization, Bridging, Side-Lying Trunk Lifts, Quadruped, Kneeling and modified plantigrade positioning) exercises. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.

Core stabilization exercises techniques Core activated by Bio Feedback apparatus and participants were given instructions to do trunk curls in crook lying position. Asked to lift their upper trunk slightly (15 degree) from the plinth. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.

Trunk control exercises Different trunk exercises were performed by the participants to develop trunk control and balance. Rhythmic stabilization, Side-Lying Trunk Lifts, Bridging, Quadruped, Kneeling and modified plantigrade positioning, are the trunk exercises which were used conventionally to develop trunk control. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.

Outcomes Measures Trunk Impairment Scale (TIS) is a standardized scale to assess the trunk function and stability in stroke patients(39). We used the pre- and post-intervention scores of Trunk Impairment Scale (TIS) to evaluate trunk function and stability.

Berg Balance Scale (BBS) is identified as the most commonly used as an evaluation tool in the stroke rehabilitation(40). We used the pre- and post-intervention scores of Berg Balance Scale (BBS) to evaluate the balance.

Data Collection Procedure The study was conducted by informed consent from participants. Assessment was performed before the intervention and after the intervention (after 6 weeks) from Trunk Impairment Scale (TIS) and Berg Balance Scale (BBS). Pre-interventional and post interventional scores were documented and analyzed the according to the statistical method.

Study Type

Interventional

Enrollment (Estimated)

38

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Rawalpindi, Punjab Province, Pakistan
        • Recruiting
        • Ghurki Trust & Teaching Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Participants between the ages of 45 and 60 years.
  • Sub-acute phase of unilateral ischemic stroke.
  • More than two weeks but no more than six months were included.
  • Participants should be able to walk with or without support for 2-4 min.
  • Participants with modified Ashworth scale grade 1 or grade 2.
  • Participants should be able to understand and follow simple verbal instructions (Mini-Mental Status Examination [MMSE]≥24).

Exclusion Criteria:

  • Participants with recurrent stroke; brainstem or cerebellar stroke or hemorrhagic stroke.
  • Participants with modified Ashworth scale grade ≥3 (severe spasticity).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group
Participants who were included in this group got Pelvic Proprioceptive neuromuscular facilitation techniques + core strengthening group + Trunk control exercises (Conventional treatment).
Other: Core stabilization exercises
Core activated by Bio Feedback apparatus and participants were given instructions to do trunk curls in crook lying position. Asked to lift their upper trunk slightly (15 degree) from the plinth. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.
Other: PNF
Proprioceptive neuromuscular facilitation techniques The sequence was rhythmic initiation, slow reversal then agonistic reversals. each technique was applied for 3 sets of 2 min duration each with 30 sec between each set and 2 min rest after each technique. A stopwatch was used to measure the time.
Other: Trunk control exercises
Trunk control exercises Different trunk exercises were performed by the participants to develop trunk control and balance. Rhythmic stabilization, Side-Lying Trunk Lifts, Bridging, Quadruped, Kneeling and modified plantigrade positioning, are the trunk exercises which were used conventionally to develop trunk control. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.
Other: Control Group
Participants in group 2 received Core stabilization exercises + Conventional trunk control exercises (Rhythmic stabilization, Bridging, Side-Lying Trunk Lifts, Quadruped, Kneeling and modified plantigrade positioning) exercises. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.
Other: Core stabilization exercises
Core activated by Bio Feedback apparatus and participants were given instructions to do trunk curls in crook lying position. Asked to lift their upper trunk slightly (15 degree) from the plinth. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.
Other: Trunk control exercises
Trunk control exercises Different trunk exercises were performed by the participants to develop trunk control and balance. Rhythmic stabilization, Side-Lying Trunk Lifts, Bridging, Quadruped, Kneeling and modified plantigrade positioning, are the trunk exercises which were used conventionally to develop trunk control. 3 sets with 10 repetitions each, 3 sec rest between each repetition, 1 min rest after each set and 3 min rest between each exercise.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Trunk Impairment Scale
Time Frame: • Baseline • After 6 weeks
The Trunk Impairment Scale (TIS) is a 17-item clinical tool assessing stroke patients across three subscales-static sitting balance (0-7 points), dynamic sitting balance (0--10points), and trunk coordination (0-6 points)-totaling a maximum score of 23. Higher scores indicate better, more controlled, and coordinated trunk function, with evaluations performed in a seated position.
• Baseline • After 6 weeks
Berg Balance Scale
Time Frame: • Baseline • After 6 weeks
Berg Balance Scale (BBS) is identified as the most commonly used as an evaluation tool in the stroke rehabilitation. We used the pre- and post-intervention scores of Berg Balance Scale (BBS) to evaluate the balance. Total score of berg balance scale is 56.Highest score shows the low fall risk and the lowest score shows the high fall risk.
• Baseline • After 6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Lahore University of Biological and Applied Sciences

Investigators

  • Study Chair: Nabeela Dawood, Lahore University of Biological and Applied Sciences

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 25, 2025

Primary Completion (Estimated)

May 25, 2026

Study Completion (Estimated)

May 30, 2026

Study Registration Dates

First Submitted

December 23, 2025

First Submitted That Met QC Criteria

January 27, 2026

First Posted (Actual)

February 2, 2026

Study Record Updates

Last Update Posted (Actual)

February 2, 2026

Last Update Submitted That Met QC Criteria

January 27, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UBAS/ERB/FoRS/25/21686

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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