Abstract
Objective
To systematically review the effect of core stability exercises in addition to usual
care physiotherapy on patient outcomes after stroke.
Data Sources
Cumulative Index to Nursing and Allied Health, MEDLINE, Physiotherapy Evidence Database
(PEDro), PubMed, and EMBASE were searched to November 2018.
Study Selection
Eleven randomized controlled trials that compared usual care physiotherapy with usual
care physiotherapy with additional core stability exercises in people with stroke
were included. The initial search yielded 1876 studies.
Data Extraction
Two independent reviewers applied inclusion and exclusion criteria and extracted data
on methodological quality using the PEDro scale, participant characteristics, intervention
details, outcome measures, and results.
Data Synthesis
Postintervention means and SDs were pooled to calculate either the standardized mean
difference (SMD) or the mean difference (MD) and 95% CIs using a random-effects model
and inverse variance methods. There was moderate quality evidence to suggest the addition
of core stability exercises to usual care physiotherapy improved trunk control (SMD,
0.94; 95% CI, 0.44-1.44; I2=69%), functional dynamic balance (SMD, 1.23; 95% CI, 0.5-1.97; I2=71%), and walking speed (MD, 0.27m/s; 95% CI, 0.01-0.52; I2=40%) in people with acute and chronic stroke. No significant effect was found when
assessing functional ambulation categories or the timed Up and Go test, and mixed
results were found for global functioning.
Conclusions
The addition of core stability exercises to usual care physiotherapy after stroke
may lead to improved trunk control and dynamic balance. Therefore, core stability
exercises should be included in rehabilitation if improvements in these domains will
help clients achieve their goals. Future trials should consider incorporating outcomes
of body kinematics during functional tasks to assess movement quality and assess participation
outcomes.
Keywords
List of abbreviations:
MD (mean difference), PEDro (Physiotherapy Evidence Database), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 21, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
