Improve Trunk Control Research Articles

Effects of Reformer-based Trunk Stability Exercise on Trunk Control, Balance, and Gait Parameters in Patients with Chronic Stroke

Background Stroke patients experienced a decline in balance and gait abilities due to impaired trunk control. Previous studies showed that Reformer exercises were effective in improving trunk control. Objective This study aimed to investigate the effects of Reformer-based trunk stability exercises on trunk control, balance, and gait abilities in patients with chronic stroke. Methods This study utilized a randomized controlled trial design. Participants were randomly assigned to an experimental group (Reformer-based trunk stability exercises, n = 12) or a control group (conventional trunk stability exercises, n = 12). The intervention consisted of 20-min sessions conducted five times a week for four weeks. Trunk control, balance, and gait parameters were evaluated before and after the intervention, and the data were analyzed using a two-way repeated measures ANOVA. Results Statistical analysis demonstrated a significant interaction effect between group and time for most variables, with within-group comparisons showing significant differences before and after the intervention for the majority of variables in both groups. Additionally, effect size analysis indicated large effect sizes (Cohen's d > 0.8) for most variables. Conclusions Reformer-based trunk stability exercises showed positive effects on trunk control, balance, and gait parameters in patients with chronic stroke.

Therapeutic Intervention for Trunk Control Impairments in Central Nervous System Disorders: A Comprehensive Review of Methods and Efficacy

Trunk control involves multiple brain regions related to motor control systems. Therefore, patients with central nervous system (CNS) disorders frequently exhibit impaired trunk control, decreasing their activities of daily living (ADL). Although some therapeutic interventions for trunk impairments have been effective, their general effects on CNS disorders remain unclear. This review aimed to clarify this issue in patients with stroke, cerebellar ataxia, and Parkinson's disease (PD), representing trunk control impairment by lesions in the cortical and corticospinal systems, cerebellum, and basal ganglia, respectively. Using online databases, we searched for randomized controlled trials that investigated the effects of therapeutic interventions for trunk impairments in patients with stroke, cerebellar ataxia, and PD, reported in English from 2013 to 2023. Overall, 50 articles were reviewed. Core-stability exercise (CSE), which activates the trunk muscles, specifically in the lumbar and pelvic areas, through postural adjustment tasks, is effective in patients with stroke, cerebellar ataxia, and PD. Weight-shifting exercise, unstable surface training, training with transcutaneous electrical stimulation, and noninvasive brain stimulation have been effective in patients following stroke. The combination of CSE with task-oriented training based on daily activities has been effective in patients with cerebellar ataxia. Perceptual training, repetitive trans-spinal magnetic stimulation, and aquatic training effectively improved alignment and balance function in patients with PD. This review provides evidence-based strategies to improve trunk control, ADL, and quality of life for patients with trunk control impairments caused by CNS disorders.

Muscle Tone and Stiffness Comparison in Ambulatory Children With Unilateral Spastic Cerebral Palsy: Implications for Postural Balance and Functional Mobility.

To compare muscle tone and stiffness in ambulatory children with unilateral spastic cerebral palsy (UCP) with typically developing peers and explore their relationship with postural balance and functional mobility. Forty ambulatory children with UCP and age-matched typically developing peers were assessed for tone and stiffness of lumbar spinal extensors, gastrocnemius, and hamstring muscles using a myotonometer. Functional mobility was evaluated with the 2-Minute Walk Test, and the Timed Up and Go Test, while postural balance was evaluated using the Pediatric Balance Scale and the Trunk Control Measurement Scale (TCMS). The gastrocnemius muscle tone and stiffness were higher on the affected side in UCP compared with the less affected side and typically developing peers (P < .05). Lumbar spinal extensor tone correlated with improved Trunk Control Measurement Scale scores (P = .003). The gastrocnemius and hamstring muscles' tone and stiffness did not significantly affect functional mobility measures in UCP (P > .05). Our study highlights the importance of achieving muscle symmetry, particularly in the plantar flexors, for functional mobility in UCP children. While differences in ankle and knee muscle biomechanics were observed, they didn't significantly impact functional mobility or postural balance. Symmetry in lumbar spinal extensor biomechanics correlated with better outcomes, emphasizing the crucial role of trunk control in rehabilitation strategies for ambulatory children with UCP.

Effects of abdominal muscle strengthening and pelvic control exercises on trunk control and pelvic movement in children with unilateral cerebral palsy.

Children with unilateral cerebral palsy (CP) exhibit abnormal movements due to atypical pelvic movements and weakness of trunk muscles. We investigated the effects of abdominal muscle strengthening and pelvic control exercises on trunk control, abdominal muscle thickness change rate, and pelvic movement in children with unilateral CP. Fourteen children with unilateral CP were randomly divided into two groups, and abdominal muscle strengthening and pelvic control exercises were applied to the experimental group, and general physical therapy was applied to the control group, 30 min per session, twice a week, for a total of 8 weeks, respectively. The trunk control measurement scale (TCMS) was used to measure trunk control, ultrasonography was used to measure abdominal muscle thickness change rate, and a wearable gait analysis system was used to measure pelvic movement. As a result, in the experimental group, TCMS showed a significant increase within the group, and the rotation range of the pelvis significantly decreased within the group on the affected and nonaffected sides. There was a significant difference between the groups in the abdominal muscle thickness change rate of the internal oblique on the affected side. Improving trunk control through abdominal strengthening and pelvic control exercises affected the deep muscles on the affected side and contributed to a reduction in excessive pelvic rotation range. Therefore, abdominal muscle strengthening and pelvic control exercises may be suggested as intervention methods to improve function in unilateral CP.

Effects Of Bilateral Upper Extremity Exercises Training On Trunk Performance, Posture And Gait In Patients With Subacute Stroke-A Quasi Experimental Study

Background and objective: Stroke is one of the neurological disorders which is caused by disturbance in blood supply to the brain resulting in weakness in contralateral limbs and axial musculature. Stroke is the leading cause of physical impairment where the most prominent motor deficit is paresis of one side of body, which is contralateral to the event. This study was conducted with an aim to assess the effectiveness of bilateral upper extremity training on trunk performance, posture and gait in patients with subacute stroke. Method: 30 subjects with subacute stroke were selected for the study. Subjects were treated for 3 days/week for 12 sessions with 45 minutes of task oriented, strengthening training and PNF technique for bilateral upper extremity along with conventional training. The rehabilitation protocol consists of bilateral functional exercises, activity of daily living goal, exercises in multiple movement games, strengthening exercises for lower limb, controlled sitting training, sit to stand training, weight bearing and balance training Conclusion: Significant improvement in all items of TIS, PASS and DGI were observed after intervention (P&lt; 0.001). The study concluded that bilateral upper extremity training is more effective in improving trunk control, posture and gait in subacute stroke patients.

Effect of Virtual Reality on Trunk Control in Children with Developmental Delays

Background: Developmental delays affect motor function and trunk control in children, impacting their overall development and daily activities. Virtual reality (VR) interventions have the potential to enhance motor abilities through engaging, personalized therapies.Objective: This study aimed to determine the effectiveness of virtual reality-based neurodevelopmental treatment with trunk control exercises (VR-NDT-TCE) in improving trunk control and cognitive functions in children with developmental delays.Methods: A single-blinded randomized controlled trial was conducted with 22 children aged 2-8 years diagnosed with developmental delays. Participants were randomly assigned to Group A (NDT-TCE) or Group B (VR-NDT-TCE) for a six-week intervention, three times per week. Trunk control was measured using the Trunk Control Measurement Scale (TCMS), and cognition was assessed through the Hammersmith Infant Neurological Examination (HINE) Performa. Data analysis was performed using SPSS version 27 with paired t-tests and Mann-Whitney tests.Results: Significant improvements were observed in trunk control (TCMS score: 20.18 ± 2.40 in Group A vs. 24.18 ± 4.67 in Group B, p = 0.017). Group B showed notable gains in cognitive parameters, including conscious state (p &lt; 0.001), emotional state (p = 0.012), and social orientation (p = 0.031).Conclusion: VR-NDT-TCE significantly improved trunk control and cognitive outcomes, offering an effective intervention for children with developmental delays.

Intracranial Hemorrhage-Is Very Early Rehabilitation Safe? A Narrative Review.

Intracerebral hemorrhage (ICH) is a serious neurological disease with a 30-day mortality rate of 34-50%. Rehabilitation can reduce disability and improve recovery from a stroke; however, it is uncertain whether early rehabilitation is safe. There are many studies and reviews on rehabilitation for chronic conditions, but there is not enough information on the details of rehabilitation in the acute and subacute phases of ICH. We analyzed clinical trials from the electronic databases PubMed, PubMedCentral, Medline, Cochrane Library, Embase, Scopus and PEDro. Based on the data, we determined that early rehabilitation of patients with ICH has beneficial effects on improving ADL scores, motor function, functional independence, quality of life, improved gait, improved trunk control and reduced mortality. Varying the duration and intensity of rehabilitation in patients with ICH may improve health status, functional outcomes and reduce the length of stay in the hospital. The earliest protocol for initiating rehabilitation after ICH included up to 24 h after stroke onset. The medical literature indicates the need for more randomized controlled group trials of early rehabilitation in patients with acute and subacute ICH with a precise timing of rehabilitation initiation. This narrative review aims to summarize the existing evidence and provide insights into the current state of knowledge regarding the safety of early rehabilitation. There is a need for a clear definition of "early rehabilitation" when determining the most appropriate time to begin rehabilitation therapy.

A Strong Core for a Strong Recovery: A Scoping Review of Methods to Improve Trunk Control and Core Stability of People with Different Neurological Conditions

Objective: The purpose of this scoping review is to provide valuable insights for clinicians and researchers for designing rehabilitative interventions targeting the trunk and core for individuals who have experienced traumatic events, such as stroke or spinal cord injury, or are grappling with neurological diseases such as multiple sclerosis and Parkinson’s disease. We investigated training methods used to enhance balance, trunk control, and core stability. Methods: We conducted an extensive literature search across several electronic databases, including Web of Science, PubMed, SCOPUS, Google Scholar, and IEEE Xplore. Results: A total of 109 articles met the inclusion criteria and were included in this review. The results shed light on the diversity of rehabilitation methods that target the trunk and core. These methods have demonstrated effectiveness in improving various outcomes, including balance, trunk control, gait, the management of trunk muscles, overall independence, and individuals’ quality of life. Conclusions: Our scoping review provides an overview on the methods and technologies employed in trunk rehabilitation and core strengthening, offering insights into the added value of core training and specific robotic training, focusing on the importance of different types of feedback to enhance training effectiveness.

A Study to Find Out Effect of Trunk Training Exercises on Trunk Control by using Swiss Ball in Parkinson’s Patients: An Experimental Study

Background: The trunk being central key point of body, proximal trunk control is a pre-requisite for distal limb movement control, balance and functional activities. Sufficient trunk stability and control of trunk movements are essential for postural stability and normal gait as the upper body constitutes two thirds of the total body weight. In Parkinson’s disease approximately 13% to 33% of patients present with postural instability as their initial motor symptom. So, purpose of this study was to compare the effect of Swiss ball trunk training exercise and trunk exercise on a bed for trunk control in Parkinson’s patients. Method: Total 30 Parkinson’s patient were selected for the study as per selection criteria and divided into two groups (15 in each group). group A was treated with trunk exercise on Swiss ball and group B was treated with trunk exercise on bed. each subject received treatment for 3 weeks,4 days/week.an assessment was done prior to treatment and after 3 weeks using Trunk Impairment Scale test. Inter-group analysis by unpaired t-test showed statistically significant improvement on Trunk Impairment Scale. (P value ≤0.05) Conclusion: The Swiss ball trunk training exercise and trunk exercise on a bed had a significant effect on trunk control. Out of the two treatment Swiss ball trunk training had a more significant effect on improving trunk control.

Therapists and patients perceptions of a mixed reality system designed to improve trunk control and upper extremity function

A prototype system aimed at improving arm function and trunk control after stroke has been developed that combines mixed-reality (MR) feedback with a mobile seat system (Holoreach). The purpose of this study was to assess the usability of Holoreach in a rehabilitation setting from both the patient and therapist perspective. Ten therapists (eight physiotherapists and two occupational therapists) used the device in their regular therapy programs for fifteen stroke patients with trunk control issues. Each patient received four individual therapy sessions with the device performed under the supervision of the therapist. Therapists and patients kept therapy diaries and used customized questionnaires. At the end of the study two focus groups were conducted to further assess usability. Generally, the prototype system is suitable for training trunk and arm control. The therapists expressed overall positive views on the impact of Holoreach. They characterized it as new, motivating, fresh, joyful, interesting, and exciting. All therapists and 80% of the patients agreed with the statement that training with Holoreach is beneficial for rehabilitation. Nonetheless, improvements are required in the hardware and software, and design. The prototype system contributes at various levels to the rapidly evolving advances in neurorehabilitation, particularly regarding the practical aspect of exercise delivery.

Effectiveness of Abdominal Activation on Motor Control in Diplegic Cerebral Palsy: A Randomized Control Trial

Background: Cerebral palsy (CP) is a disorder of the nervous system manifested in movement, posture, muscle tone, and functional activity. Poor postural control is the most common problem related to CP. Neuro-developmental techniques, or facilitation techniques, were used to activate muscles and improve trunk control. Aim: To determine the influence of the effects of abdominal activation for correcting posture in spastic diaplegic CP children. Methods: A quantitative, randomized clinical trial was conducted, allocating 26 CP patients randomly into two groups: the control group and the treatment group. Baseline treatment was given to the control group, which included lower-limb passive stretching exercises and interrupted direct current. However, baseline treatment with neuro-developmental techniques was given to the treatment group. The measuring tool used for assessment of postural correction and stability was the trunk control measurement scale. Results: The study recruited 26 CP patients, of who 10 belonged to the age groups 8–10 years and 11–13 years, respectively, while 6 children were from the age group 14–15 years. An independent sample t-test was used for between-group analysis, and the results showed a significant improvement in the TCMS score post-treatment, as the p-value was 0.012, while within-group analysis was done by applying a paired sample t-test. There was a significant improvement in the treatment group (p-value 0.000) where NTD was applied, compared to the control group (p-value 0.096), where only baseline treatment was given. Implication: Neurodevelopmental approaches can improve trunk control in children with cerebral palsy, enhancing mobility, independence, posture, and functional skills. This reduces the risk of musculoskeletal issues and facilitates activity participation. Conclusion: The study showed significant improvement in postural control with the use of Neuro-developmental techniques in CP children. Children with cerebral palsy (CP) can benefit from improved trunk control using neurodevelopmental approaches, which can increase their mobility, independence, posture, ability to participate in activities, and functional skills. Keywords: Cerebral palsy (CP), Neuro-developmental techniques (NDT), Interrupted direct current (IDC).

Monitoring muscle activity in pediatric SCI: Insights from sensorized rocking chairs and machine-learning.

Introduction: Activity-based therapy is effective at improving trunk control in children with spinal cord injury. A prototype sensorized rocking chair was developed and confirmed as an activity that activates trunk muscles. This study uses data collected from the chair to predict muscle use during rocking. Methods: The prototype rocking chair included sensors to detect forces, accelerations, as well child and chair movement. Children with spinal cord injury and typically developing children (2-12years), recruited under an approved IRB protocol, were observed rocking while sensor and electromyography data were collected from arm, leg, and trunk muscles. Features from sensor data were used to predict muscle activation using multiple linear regression, regression learning, and neural network modeling. Correlation analysis examined individual sensor contributions to predictions. Results: Neural network models outperformed regression models. Multiple linear regression predictions significantly correlated (p < 0.05) with targets for four of eleven children with SCI, while decision tree regression predictions correlated for five children. Neural network predictions correlated for all children. Conclusions: Embedded sensors capture useful information about muscle activation, and machine learning techniques can be used to inform therapists. Further work is warranted to refine prediction models and to investigate how well results can be generalized.

İnme Sonrası Hastalarda Gövde Performansı ile Üst Ekstremite Fonksiyonları, Denge, Fonksiyonel Hareketlilik ve Günlük Yaşam Aktiviteleri Arasındaki İlişkinin İncelenmesi

Investigation of The Relationship Between Trunk Performance and Upper Extremity Functions, Balance, Functional Mobility and Activities of Daily Living In Post-Stroke Patients Introduction: Stroke and related disabilities often lead to pain and weakness in the trunk, affecting daily life activities. Trunk impairment, characterized by muscle weakness, is a significant factor limiting motor recovery after stroke. Trunk stability is crucial for postural balance, upper extremity function, and daily activities. Therefore, early acquisition of trunk control is essential in stroke rehabilitation. Despite its importance, the relationship between trunk performance and upper extremity function, balance, and daily life activities in post-stroke patients remains understudied. Materials and Methods: Fifty post-stroke patients aged 65 to 81 were included in the study, meeting specific inclusion criteria. Trunk performance was assessed using the Trunk Impairment Scale (TIS), while upper extremity function, balance, and daily life activities were evaluated using various tests, including the Wolf Motor Function Test (WMFT), Berg Balance Scale (BBS), Time Up and Go (TUG), and Functional Independence Measure (FIM). Data analysis was conducted using SPSS 22.0, and Pearson Correlation Tests were employed to examine the interrelations between evaluation parameters. Results: The study found no significant correlations between trunk performance (TIS) and balance measurements (BBS and TUG) or between trunk performance and upper extremity functions (WMFT) and daily life activities (FIM). Discussion: While previous research has emphasized the importance of trunk control in post-stroke rehabilitation, our study did not identify significant correlations between trunk performance and other functional parameters. This discrepancy may be due to the specific evaluation parameters used in our study, which focused on sitting posture for trunk performance, while other assessments primarily targeted standing and walking activities. Conclusion: In conclusion, this study suggests that there is no significant relationship between trunk performance and upper extremity function, balance, and daily life activities in post-stroke patients. However, the existing literature highlights the critical role of trunk control in post-stroke rehabilitation. Trunk control should be considered an essential skill to regain functional independence, walking ability, and upper extremity use after a stroke. Rehabilitation programs should prioritize interventions to improve trunk control, especially in the early stages of recovery, to enhance the overall outcomes of post-stroke patients. Key Words: Trunk Performance, Post-Stroke Rehabilitation, Upper Extremity Function, Balance Assessment, Daily Life Activities.

Does the Bobath approach improve trunk control in acute stroke patients?

Does the Bobath approach improve trunk control in acute stroke patients?

Task-Oriented Training with Abdominal Drawing-in Maneuver in Sitting Position for Trunk Control, Balance, and Activities of Daily Living in Patients with Stroke: A Pilot Randomized Controlled Trial

In many patients with stroke, trunk stabilization and balance are decreased. Trunk stabilization and balance are important to perform posture control and functional movement. This study investigates the effects of task-orientated training with the abdominal drawing-in maneuver in a sitting position on trunk control, balance, and activities of daily living in patients with chronic stroke. The study design is a randomized controlled trial. Thirty-eight patients with chronic stroke participated in this study. The task-oriented training combined with the abdominal drawing-in maneuver group (n = 13), the task-oriented training group (n = 13), and the control group (n = 12) received traditional physical therapy. Three groups participated in a total of 20 sessions, four times a week for five weeks. After the five-week training period, trunk control, balance, and activities of daily living were assessed. The task-oriented training combined with the abdominal drawing-in maneuver group demonstrated significant improvements in trunk control, balance, and activities of daily living compared to the task-oriented training and control groups (p &lt; 0.05). These results have implications for improving trunk control, balance, and activities of daily living for patients with stroke, and support the integration of this training method into standard clinical practice.

Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury.

Cervical spinal cord injury (SCI) leads to impaired trunk motor control, negatively impacting the performance of activities of daily living in the affected individuals. Improved trunk control with better sitting posture has been previously observed due to neuromuscular electrical stimulation and transcutaneous spinal stimulation, while improved postural stability has been observed with spinal cord epidural stimulation (scES). Hence, we studied how trunk-specific scES impacts sitting independence and posture. Fourteen individuals with chronic, severe cervical SCI with an implanted neurostimulator performed a 5-min tall-sit task without and with trunk-specific scES. Spine posture was assessed by placing markers on five spine levels and evaluating vertical spine inclination angles. Duration of trunk manual assistance was used to assess independence along with the number of independence changes and average independence score across those changes. With scES, the sacrum-L1 inclination and number of independence changes tended to decrease by 1.64 ± 3.16° (p = 0.07; Cohen's d = 0.53) and 9.86 ± 16.8 (p = 0.047; Cohen's d = 0.59), respectively. Additionally, for the participants who had poor sitting independence without scES, level of independence tended to increase by 12.91% [0%, 31.52%] (p = 0.38; Cohen's d = 0.96) when scES was present. Hence, trunk-specific scES promoted improvements in lower spine posture and lower levels of trunk assistance.

The effects of gastrocnemius muscle spasticity on gait symmetry and trunk control in chronic stroke patients

BackgroundAlthough reduced gait asymmetry and trunk control are generally accepted outcomes in stroke patients after having a stroke, the number of studies examining the factors affecting gait symmetry and trunk control is limited in the literature. Research questionWhat are the effects of gastrocnemius muscle spasticity on trunk control and gait symmetry in chronic stroke patients? MethodThe sample of the study included 29 individuals aged 40–70 who were diagnosed with stroke at least six months ago. The sociodemographic information of the patients was collected using a descriptive information form. Their gastrocnemius muscle spasticity levels were assessed using the Modified Ashworth Scale (MAS), their trunk control was assessed using the Trunk Impairment Scale (TIS), and their gait symmetry was assessed using software developed for the Kinect V2 camera. ResultsThere was a numerical difference between the gait symmetry results of the patients who had a MAS score lower than 2 and those who had a MAS score of 2 or higher, where MAS scores corresponded to gastrocnemius muscle spasticity levels, but this difference was not statistically significant (p > 0.05). There was a statistically significant difference between the total TIS scores and TIS coordination subscale scores of the patients who had a MAS score lower than 2 and those who had a MAS score of 2 or higher (p < 0.05). A negative significant relationship was determined between total TIS and TIS coordination subscale scores and the severity of gastrocnemius muscle spasticity. SignificanceAccording to the results of our study, to improve trunk control and gait in stroke survivors, the management of gastrocnemius muscle spasticity should be included in rehabilitation programs. We believe that our study will be guiding for future interventional studies aiming to improve trunk control and gait in stroke patients.

Fall Prevention Training for Service Members With an Amputation or Limb Salvage Following Lower Extremity Trauma.

Recent military conflicts have resulted in a significant number of lower extremity injuries to U.S. service members that result in amputation or limb preservation (LP) procedures. Service members receiving these procedures report a high prevalence and deleterious consequences of falls. Very little research exists to improve balance and reduce falls, especially among young active populations such as service members with LP or limb loss. To address this research gap, we evaluated the success of a fall prevention training program for service members with lower extremity trauma by (1) measuring fall rates, (2) quantifying improvements in trunk control, and (3) determining skill retention at 3 and 6 months after training. Forty-five participants (40 males, mean [±SD] age, 34 ± 8 years) with lower extremity trauma (20 with unilateral transtibial amputation, 6 with unilateral transfemoral amputation, 5 with bilateral transtibial amputation, and 14 with unilateral LP procedures) were enrolled. A microprocessor-controlled treadmill was used to produce task-specific postural perturbations which simulated a trip. The training was conducted over a 2-week period and consisted of six 30-minute sessions. The task difficulty was increased as the participant's ability progressed. The effectiveness of the training program was assessed by collecting data before training (baseline; repeated twice), immediately after training (0 month), and at 3 and 6 months post-training. Training effectiveness was quantified by participant-reported falls in the free-living environment before and after training. Perturbation-induced recovery step trunk flexion angle and velocity was also collected. Participants reported reduced falls and improved balance confidence in the free-living environment following the training. Repeated testing before training revealed that there were no pre-training differences in trunk control. The training program improved trunk control following training, and these skills were retained at 3 and 6 months after training. This study showed that task-specific fall prevention training reduced falls across a cohort of service members with diverse types of amputations and LP procedures following lower extremity trauma. Importantly, the clinical outcome of this effort (i.e., reduced falls and improved balance confidence) can lead to increased participation in occupational, recreational, and social activities and thus improved quality of life.

Exercise efficacy in management of Cervical Spondylotic Myelopathy – A case report

Cervical Spondylotic Myelopathy is an ageing, degenerative spinal condition and a common cause of myelopathy in adults, with the average age of presentation being 56 years. This case report was on a 63-year man who was apparently healthy until he was presented with grade v on Nurick Classification System for Myelopathy. Lhermitte Sign was present. The clinical presentations were motor deficit in the upper limbs (ULs), lower limbs (LLs) and hands; intermittent bouts of spasms in lower limbs; painfully reduced range of motion (ROM) in the shoulder, cervical and lumbosacral joints; impaired activity of daily living (ADL) including ambulation, and reduced sleeping hours. The treatment plan aimed to relieve pain at the affected joints; improve ROM in joints of ULs and LLs; strengthen weak muscles (ULs and LLs); improve trunk control; improve patella mobility and release of tight muscle/structures(hamstrings). The adopted Exercise protocols, which were done between 11 am-1 pm at thrice weekly appointments for four months, were Mobilization &amp; Strengthening Exercises (all limbs); Back Flexibility Exercises; Quadriceps Strengthening Exercises both LLs and Neuromotor Exercises. The patient became stable on a tripod stand in the fourth month and was discharged on a home programme at the end of the fourth month. The observed improvement in the clinical condition of this Cervical Spondylotic Myelopathy patient lays credence to the efficacy of the use of exercise interventions in this condition.

Effectiveness of cerebellar vermis intermittent theta-burst stimulation in improving trunk control and balance function for patients with subacute stroke: a randomised controlled trial protocol

IntroductionBalance impairments frequently occur after stroke. Achieving effective core trunk stability is the key to improving balance ability. However, there is still a lack of advanced well-defined rehabilitation protocols for...