Role of Trunk Rehabilitation on Trunk Control, Balance and Gait in Patients with Chronic Stroke: A Pre-Post Design

Abstract

Purpose: Although proximal stability of the trunk is a prerequisite for balance and gait, to determine the role of trunk rehabilitation on trunk control, balance and gait in patients with chronic stroke is yet unknown. Method: Fifteen sub-jects (post-stroke duration (3.53 ± 2.98) years) who had the ability to walk 10 meters independently with or without a walking aid; scoring ≤ 21 on Trunk Impairment Scale (TIS), participated in a selective trunk muscle exercise regime, consisting of 45 minutes training per day, four days a week, and for four weeks duration in an outpatient stroke reha-bilitation centre. Results: The overall effect size index for trunk rehabilitation was 1.07. This study showed large effect size index for Trunk Impairment Scale (1.75), Berg Balance Scale (1.65) than for gait variables (0.65). After trunk rehabilitation, there was a significant improvement for gait speed (p= 0.015), cadence (p= 0.001) and gait symmetry (p=0.019) in patients with chronic stroke. In addition, all the spatial gait parameters had a significant change post-intervention. There was no significant change in temporal gait parameters with the exception of affected single limb support time. The level of significance was set at p < 0.05. Conclusion: The exercises consisted of selective trunk movement of the upper and the lower part of trunk had shown larger effect size index for trunk control and balance than for gait in patients with chronic stroke. Future randomized controlled studies incorporating large sample size would provide insight into the effectiveness and clinical relevance of this intervention.