Is trunk training effective at improving ability in activities of daily living and function of people who have had a stroke? A Cochrane Review summary with commentary

Background: Effective trunk control is an essential component of sitting and standing balance, and is a key requirement for movement of the head and limbs, and for carrying out functional tasks. A stroke can result in impaired trunk control, affected by stroke-related deficits in balance, muscle function, coordination and position sense. Recovery of trunk control is recognised as a key goal of stroke rehabilitation.

Objective: To evaluate the effectiveness of trunk training interventions in people with stroke.

Methods: A summary of the Cochrane Review by Thijs et al. (2023), with comments from a rehabilitation perspective.

Results: 68 studies (2585 participants) were included in the Cochrane review. Trunk training was not found to have any benefit on measures of ADL, when compared to other dose-matched therapies, but did improve trunk function and other outcomes. Trunk training was more beneficial than non-dose-matched therapies for measures of ADL, trunk function, and other outcomes. The certainty of these findings is very low.

Conclusion: Evidence supports the use of trunk training as part of stroke rehabilitation. However certainty in these findings is very low due to volume, quality and heterogeneity of the evidence.