Inpatient trunk exercises after recent stroke: An update meta-analysis of randomized controlled trials

Souza, Daniele Costa Borges; Sales, Matheus; Ribeiro, Nildo Manoel da Silva; Maldonado, Igor Lima

doi:10.3233/nre-182585

Cited by 22 publications

(23 citation statements)

References 22 publications

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“…Our results confirmed prior evidence [8][9][10][11] regarding the positive effect of ATEP on trunk function recovery by SMD 1.06 (CI 0.74-1.37) and balance ability (SMD 0.83; CI 0.52-1.14). The improvement on trunk function caused by ATEP represented a 13% higher than the improvement showed by the conventional therapy alone, which is equal to 3 points on the Trunk Impairment Scale (TIS).…”

Section: General Effects Of Atepsupporting

confidence: 91%

“…The relevance of trunk control in this population is also supported by several longitudinal studies showing that the degree of trunk impairment seems to determine, to what extent, patients recover their motor function months after stroke-onset [5][6][7]. Based on these findings, the need to introduce trunk-focused exercises in stroke rehabilitation programs has increased [8][9][10][11].…”

Section: Introductionmentioning

confidence: 78%

“…Because of evidence leading towards an association between trunk function and motor performance in stroke patients, meta-analyses have been performed in order to obtain more in-depth knowledge about the effectiveness of additional trunk-focused exercise programs (ATEP) in conventional stroke rehabilitation programs to restore motor function [8][9][10][11]. In general, their results showed a positive impact of trunk-focused exercises on variables, such as trunk function, balance, and functional mobility.…”

Section: Introductionmentioning

confidence: 99%

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Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses

Prat-Luri

Moreno-Navarro

García

et al. 2020

IJERPH

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The aim of this systematic review is to analyze how, after additional trunk-focused training programs (ATEP), motor recovery after a stroke is modulated by potential effect modifiers. Twenty randomized controlled studies that carried out ATEP were included. Results showed moderate-to-high effects in favor of ATEP for trunk function, balance ability, gait performance, and functional mobility. Studies with a higher initial trunk impairment obtained a higher effect on trunk function and balance; studies with older participants had a higher effect on trunk function, limit of stability, and functional mobility, but not on balance ability. Older and more affected patients were, as well, those who started the intervention earlier, which was also linked with higher effects on trunk function, balance, and gait performance. Longer ATEP found a high effect on trunk function and balance ability. The potential effect modifiers seem to be important in the modulation of the effectiveness of ATEP and should be considered in the design of rehabilitation programs. Thus, since potential effect modifiers seem to modulate ATEP effectiveness, future studies should consider them in their experimental designs to better understand their impact on stroke rehabilitation.

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Section: General Effects Of Atepsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses

Prat-Luri

Moreno-Navarro

García

et al. 2020

IJERPH

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“…There are few high-quality large multicenter randomized controlled trials (RCT) with patients recruited within 30 days after a stroke [ 39 ]. There is a clear need for larger trials conducted early after stroke in real-world clinical settings [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Additional Core Stability Exercises in Improving Dynamic Sitting Balance, Gait and Functional Rehabilitation for Subacute Stroke Patients (CORE-Trial): Study Protocol for a Randomized Controlled Trial

Cabanas-Valdés

Boix-Sala

Pellicer

et al. 2021

IJERPH

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Background: Trunk impairment produces disorders of motor control, balance and gait. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, balance and gait. Methods and analysis: This is a single-blind multicenter randomized controlled trial. Two parallel groups are compared, and both perform the same type of therapy. A control group (CG) (n = 110) performs conventional physiotherapy (CP) (1 h per session) focused on improving balance. An experimental group (EG) (n = 110) performs CSE (30 min) in addition to CP (30 min) (1 h/session in total). EG is divided in two subgroups, in which only half of patients (n = 55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by a Spanish version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at three weeks (T1), at five weeks (end of the intervention) (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a five-week intervention, followed by a 24-week post-intervention).

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“…There are few high-quality large multicenter randomized controlled trials (RCT) with patients recruited within 30 days after stroke (38). There is a clear need for larger trials conducted early after stroke in the real-world clinical setting (39).…”

Section: Introduction Backgroundand Rationalementioning

confidence: 99%

The effectiveness of additional core stability exercises in improving dynamic sitting balance, standing balance, lower-limb spasticity, falls and gait in subacute stroke patients (CORE-trial). Study protocol for a Randomized Controlled Trial

Cabanas-Valdés¹,

Boix-Sala²,

Pellicer³

et al. 2021

Preprint

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BackgroundTrunk impairment produces disorders of motor control, balance, and gait that are correlated with increased risk of falls and reduced mobility in stroke survivors. This creates disability and dependency to perform their activities of daily living. Alterations in body alignment occur, requiring treatment strategies focused on improving the postural control. bearing. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, dynamic sitting, standing balance, and gait. There is some evidence about its effectiveness but it is still necessary to run a large multicenter trial to ratify that existing evidence.MethodsThis is a single-blind multicenter randomized controlled trial. Two parallel groups are compared and both perform the same type of therapy. A control group (CG) (n=110) performs conventional physiotherapy (CP) (1 hour per session) focused on improving balance. An experimental group (EG) (n=110) performs CSE (30 minutes) in addition to CP (30 minutes) (1 hour/session in total). EG is divided in two subgroups, in which only half of patients (n=55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by Spanish-version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at 3 weeks (T1), at 5 weeks -at the end of the intervention (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a 5-week intervention, followed by a 24-week post-intervention). DiscussionThe study will provide useful information on the short and long term effects of a physiotherapy rehabilitation program based on core stability exercises performed in subacute phase.Trial registrationClinicalTrials.gov Identifier NCT03975985. Data registration June 5th, 2019. Retrospectively registered. Date of registration in primary registry: June 5, 2019. Protocol version 1

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Inpatient trunk exercises after recent stroke: An update meta-analysis of randomized controlled trials

Cited by 22 publications

References 22 publications

Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses

Do Initial Trunk Impairment, Age, Intervention Onset, and Training Volume Modulate the Effectiveness of Additional Trunk Exercise Programs after Stroke? A Systematic Review with Meta-Analyses

The Effectiveness of Additional Core Stability Exercises in Improving Dynamic Sitting Balance, Gait and Functional Rehabilitation for Subacute Stroke Patients (CORE-Trial): Study Protocol for a Randomized Controlled Trial

The effectiveness of additional core stability exercises in improving dynamic sitting balance, standing balance, lower-limb spasticity, falls and gait in subacute stroke patients (CORE-trial). Study protocol for a Randomized Controlled Trial

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