Do trunk exercises improve trunk and upper extremity performance, post stroke? A systematic review and meta-analysis

Background: Post-stroke trunk control is reported to be associated with trunk performance and recovery of the upper limb, but the evidence for the influence of trunk exercise on both of these is unclear. Objective: To evaluate the effect of trunk exercises on trunk performance post-stroke, and to determine if these exercises result in improved upper limb function. Methods: A comprehensive search of the literature published between January 1990 and February 2017 was conducted using the following electronic databases; AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, PsychInfo and SPORTDiscus. Only randomized, controlled trials, published in English, evaluating the effect of trunk exercises on trunk performance and/or upper limb function post-stroke, were included. Results: A total of 17 studies involving 599 participants were analysed. Meta-analysis showed that trunk exercises had a large significant effect on trunk performance post-stroke. This effect varied from very large for acute stroke to medium for subacute and chronic stroke. None of the included studies had measured the effect of trunk exercise on upper limb impairment or functional activity. Conclusions: Trunk exercises improve trunk performance for people with acute, subacute and chronic strokes. As yet there is no evidence to support the effect of trunk exercise on upper limb function.