title: Does additional exercise improve trunk function recovery in stroke patients? A meta-analysis.
abstract: BACKGROUND
  The restoration of trunk function following stroke is a key component of rehabilitation, however there is limited evidence of the efficacy of additional trunk training.
  
  
  OBJECTIVE
  To evaluate the efficacy of trunk exercises added to conventional rehabilitation on functional outcomes.
  
  
  METHODS
  Relevant randomised controlled trials (RCTs), published up to July 2012, evaluating the effect of the addition of trunk exercises to conventional rehabilitation on functional outcomes were identified in Medline, Cinahl, Embase, Pubmed, PEDro, Web of Science and Scopus databases. Findings were summarised across studies as mean or standardised mean differences (MD or SMD) with 95% confidence intervals.
  
  
  RESULTS
  Six RCTs with 155 participants and a mean PEDro score of 6.5 (range 6 to 8) were included. Data from two to five studies were pooled in meta-analyses that showed a moderate, non-significant effect of additional trunk exercise on trunk performance, (SMD = 0.50; 95% CI -0.25, 1.25; P = 0.19); large effects on standing balance, SMD = 0.72 (95% CI -0.01, 1.45 P = 0.05); and walking ability, (SMD = 0.81; 95% CI 0.30, 1.33. P = 0.002) and a small, non-significant effect, MD = 10.03 (95% CI -15.70, 35.75. P = 0.44) on functional independence.
  
  
  CONCLUSIONS
  There is moderate evidence that the addition of specific trunk exercise to conventional early stroke rehabilitation significantly improve standing balance and mobility after stroke; however the evidence was weak for the effect of additional trunk exercise on trunk performance and in functional independence.
authors.affiliation: Division of Health and Social Care Research, School of Medicine, King's College London, London, UK.
authors.forename: I O
authors.initials: IO
authors.lastname: Sorinola
authors.affiliation: Division of Health and Social Care Research, School of Medicine, King's College London, London, UK.
authors.forename: I
authors.initials: I
authors.lastname: Powis
authors.affiliation: Division of Health and Social Care Research, School of Medicine, King's College London, London, UK.
authors.forename: C M
authors.initials: CM
authors.lastname: White
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods* / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D051346:Mobility Limitation; D020127:Recovery of Function; D000071939:Stroke Rehabilitation; D060726:Torso / Q000503:physiopathology*
keywords: Meta-analysis; functional recovery; mobility; rehabilitation; stroke; trunk exercise