Do core stability exercises improve upper limb function in chronic stroke patients?

Abstract

Background: Upper limb paresis is a common problem in patients with stroke. Objectives: To determine the effect of core stability exercises on upper limb function and trunk balance in hemiparetic patients. Subjects: Thirty patients with hemiparesis, with age between 45 and 60 years, and with illness duration of more than 6 months. They were assigned into two equal groups, the control group, Group A: with 15 patients who received only conventional physical therapy program; the study group, Group B: with 15 patients who received conventional physical therapy program and additional core muscle training. Patients received 18 sessions for 6 weeks, three sessions/week. Methods: The upper limb function was assessed using Wolf motor function test with subscales (function ability scale, time, and grip strength), the range of motion of shoulder flexion and abduction was measured by using goniometer, trunk balance was assessed using the trunk impairment scale with subscales (static sitting balance, dynamic sitting balance, and coordination). All measurement outcomes were assessed before and after applying the treatment program. Results: There was no statistical significant difference between two groups in pretreatment assessment using wolf motor function test, trunk impairment scale, and shoulder range of motion. In post treatment assessment, there was no statistical significant difference between group A and group B in all the outcome measures, except for trunk impairment subscale (dynamic sitting balance); the statistical significant difference was in favor of group B. Conclusion: Core muscle training is similar to conventional physical therapy program in improving upper limb function in hemiparetic patients, and has beneficial effect on improving trunk balance.

The Effectiveness of Core Exercising for Postural Control in Patients with Stroke: A Systematic Review and Meta‐Analysis

“…Figure 1 shows the flow details of the trials selected in the different phases. A total of 14 studies were identified for inclusion in the review, totaling 490 participants analyzed 8,27–39 . The characteristics of the studies included are shown on Table 1.…”

“…The characteristics of the studies included are shown on Table 1. Four studies were not included in the quantitative analysis because their outcome measures were not included in the at least three studies 30,34 or they did not provide raw data for the analysis 8,31 . They were all published between 2010 and 2019.…”

“…Some trials compared the effects of core stabilization exercises with those of conventional physical therapies, which included stretching, range‐of‐motion, strengthening, breathing‐enhanced and upper and lower extremity exercises, and passive mobilizations 8,27,28,30,31,34,35 . Other studies include balance and/or gait training 30,33,38,39 .…”

“…Core stabilization exercises focused on improving trunk stability, postural control, and static and dynamic balance 14,28–31,37 . The most frequent exercises included selective movements 27,30,32,33,36,38 bridge exercises, 8,28,31,37,39 crunch, quadruped, 31,37 and bird dog exercises 28,31,39 . Progression usually included bed exercises, wedge exercises, and exercises using a Swiss ball 29,35 …”

“…Seven randomized controlled trials used the Trunk Impairment Scale and showed significant improvements in those patients included in the core exercising group 31,32,35,37,39 whereas two studies showed a significant improvement in both groups, being higher in the experimental group 36,39 . A pooled analysis of six studies showed significant difference in Trunk Impairment Scale when core exercising added to conventional therapy or pelvic proprioceptive neuromuscular facilitation was compared with conventional or other therapy (pelvic proprioceptive neuromuscular facilitation) (mean difference 0.98; 95% confidence interval, 0.69 to 1.27; P < .001) (Figure 3).…”