The effectiveness of trunk training on Trunk Performance & trunk control in Patients With Stroke: A Systematic review.

Trunk Training Effectiveness Systematic Review.




Proprioception, Trunk Training, Physiotherapy


BACKGROUND: The trunk muscle weakness and the loss of proprioception concerning the affected side can interfere with balance, stability, and functional disability. Trunk control has been identified as an important early predictor of functional outcome after stroke.

OBJECTIVE: To explore the literature regarding the use of trunk training exercises (TTE) in patients with stroke to improve trunk performance and trunk control.

METHODS: PubMed/MEDLINE, Google Scholar, and CINHAL  databases were searched with the key words Stroke and trunk Training Exercises according to MESH criteria and reference lists screened to identify randomized controlled trials (RCTs) of trunk training exercises in stroke survivors. Two reviewers independently screened references, selected relevant studies, extracted data, and assessed trial report quality.

RESULTS: A total of 09 studies with 328 participants met the inclusion criteria.   Out of the 9 studies, 5 included both acute & subacute, 1 study included only acute & 3 only chronic patients with Stroke. Trunk training exercises, Core stability exercises and weight shifting exercises performed with either stable or unstable surfaces showed moderate evidence to improve trunk performance and Trunk Control in Patients with acute & subacute stroke.

CONCLUSION: Trunk Training Exercises performed on a stable surface have been used widely to improve Trunk control in patients with Stroke. However, its effect on functional tasks needs to be explored through well-designed research studies with specific outcome measures.

Author Biography

Prof. Ganvir Suvarna S ( PhD), Prof. and HOD, Dept. of Neurophysiotherapy,DVVPF's, College of Physiotherapy, Ahmednagar

Prof. & HOD


Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol. 2007 Feb;6(2):182–7.

Bruyneel AV, Reinmann A, Sordet C, Venturelli P, Feldmann I, Guyen E. Reliability and validity of the trunk position sense and modified functional reach tests in individuals after stroke. Physiother Theory Pract. 2022 Jul 19;1–10.

Oliveira CB, Medeiros ÍRT, Greters MG, Frota NAF, Lucato LT, Scaff M, et al. Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke. Clinics (Sao Paulo). 2011;66(12):2043–8.

Dickstein R, Shefi S, Marcovitz E, Villa Y. Electromyographic activity of voluntarily activated trunk flexor and extensor muscles in post-stroke hemiparetic subjects. Clin Neurophysiol. 2004 Apr;115(4):790–6.

Batchelor FA, Mackintosh SF, Said CM, Hill KD. Falls after stroke. Int J Stroke. 2012 Aug;7(6):482–90.

Badke MB, Duncan PW. Patterns of rapid motor responses during postural adjustments when standing in healthy subjects and hemiplegic patients. Phys Ther. 1983 Jan;63(1):13–20.

Dean C, Mackey F. Motor assessment scale scores as a measure of rehabilitation outcome following stroke. Aust J Physiother. 1992;38(1):31–5.

Verheyden G, Nieuwboer A, Feys H, Thijs V, Vaes K, De Weerdt W. Discriminant ability of the Trunk Impairment Scale: A comparison between stroke patients and healthy individuals. Disabil Rehabil. 2005 Sep 2;27(17):1023–8.

Feigin L, Sharon B, Czaczkes B, Rosin AJ. Sitting equilibrium 2 weeks after a stroke can predict the walking ability after 6 months. Gerontology. 1996;42(6):348–53.

Cooke EV, Mares K, Clark A, Tallis RC, Pomeroy VM. The effects of increased dose of exercise-based therapies to enhance motor recovery after stroke: a systematic review and meta-analysis. BMC Med. 2010 Oct 13;8:60.

Kim BH, Lee SM, Bae YH, Yu JH, Kim TH. The Effect of a Task-oriented Training on Trunk Control Ability, Balance and Gait of Stroke Patients. J Phys Ther Sci. 2012;24(6):519–22.

Ahmed U, Karimi H, Amir S, Ahmed A. Effects of intensive multiplanar trunk training coupled with dual-task exercises on balance, mobility, and fall risk in patients with stroke: a randomized controlled trial. J Int Med Res. 2021 Nov;49(11):3000605211059413.

Cabanas-Valdés R, Bagur-Calafat M, Girabent M, Caballero F, Hernández-Valiño M, Urrútia G. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: A randomized controlled trial. Clinical rehabilitation. 2015 Oct 9;30.

Lee PY, Huang JC, Tseng HY, Yang YC, Lin SI. Effects of Trunk Exercise on Unstable Surfaces in Persons with Stroke: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020 Dec 7;17(23):9135.

Van Criekinge T, Truijen S, Schröder J, Maebe Z, Blanckaert K, van der Waal C, et al. The effectiveness of trunk training on trunk control, sitting and standing balance and mobility post-stroke: a systematic review and meta-analysis. Clin Rehabil. 2019 Jun;33(6):992–1002.

Lee NG, You JSH, Yi CH, Jeon HS, Choi BS, Lee DR, et al. Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke. Arch Phys Med Rehabil. 2018 Nov;99(11):2168–74.

Haruyama K, Kawakami M, Otsuka T. Effect of Core Stability Training on Trunk Function, Standing Balance, and Mobility in Stroke Patients. Neurorehabil Neural Repair. 2017 Mar;31(3):240–9.

Hwangbo PN, Don Kim K. Effects of proprioceptive neuromuscular facilitation neck pattern exercise on the ability to control the trunk and maintain balance in chronic stroke patients. J Phys Ther Sci. 2016 Mar;28(3):850–3.

Fujino Y, Amimoto K, Fukata K, Ishihara S, Makita S, Takahashi H. Does training sitting balance on a platform tilted 10° to the weak side improve trunk control in the acute phase after stroke? A randomized, controlled trial. Top Stroke Rehabil. 2016 Feb;23(1):43–9.

Jung K, Kim Y, Chung Y, Hwang S. Weight-shift training improves trunk control, proprioception, and balance in patients with chronic hemiparetic stroke. Tohoku J Exp Med. 2014 Mar;232(3):195–9.

Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W. The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004 May;18(3):326–34.

Cabanas-Valdés R, Cuchi GU, Bagur-Calafat C. Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: a systematic review. NeuroRehabilitation. 2013;33(4):575–92.

Shin DC. Smartphone-based visual feedback trunk control training for gait ability in stroke patients: A single-blind randomized controlled trial. Technol Health Care. 2020;28(1):45–55.

Noh HJ, Lee SH, Bang DH. Three-Dimensional Balance Training Using Visual Feedback on Balance and Walking Ability in Subacute Stroke Patients: A Single-Blinded Randomized Controlled Pilot Trial. J Stroke Cerebrovasc Dis. 2019 Apr;28(4):994–1000.

VAN Criekinge T, Saeys W, Hallemans A, Herssens N, Lafosse C, VAN Laere K, et al. SWEAT2 study: effectiveness of trunk training on muscle activity after stroke. A randomized controlled trial. Eur J Phys Rehabil Med. 2021 Aug;57(4):485–94.

Cg M, C S, Rd H, Am M, M E. Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical therapy [Internet]. 2003 Aug [cited 2023 Nov 21];83(8). Available from:




How to Cite

Simran, J., & Suvarna S ( PhD), P. G. (2023). The effectiveness of trunk training on Trunk Performance & trunk control in Patients With Stroke: A Systematic review.: Trunk Training Effectiveness Systematic Review. VIMS JOURNAL OF PHYSICAL THERAPY, 5(2), 14–16.



Review Article