This study aims to assess the efficacy of trunk training treatment intensities on trunk control of stroke patients with the Trunk Impairment Scale (TIS) score. A structured literature search was performed in several databases from the first indexed article until December 2022, including PubMed, Web of Science, PEDro, Cochrane Library, and Scopus. In addition, the study selection was investigated following the PRISMA guideline. Only randomised controlled trials that examined the trunk training effectiveness on trunk control (measured by the TIS after stroke) were included. A total of 25 trials with 976 stroke patients were evaluated. Meanwhile, seven studies were classified as high bias risk. Irrespective of the training mode and methodology quality, the large effects favored trunk training compared to the control group. The sensitivity analysis revealed a large effect in favour of trunk training on trunk control [SMD = 1.16 (95% CI: 0.93-1.39); p<0.00001, I2 = 80%]. Subsequently, the most effective trunk training treatment duration was 10 hours of core stability exercise for trunk control improvement [SMD = 3.20 (95% CI: 2.25-4.15)]. The meta-regression analysis demonstrated no strong evidence of trunk training treatment intensities on the effect sizes. Trunk training was effective in trunk rehabilitation. Nonetheless, specific trunk training was required for different stroke phases. Interestingly, the effect size was meaningfully enlarged by adding 15 minutes of core stability exercise to the conventional therapy (five sessions per week over eight weeks of intervention). This result was useful in determining the number of sessions for effective trunk rehabilitation.
The Efficacy of Trunk Training Treatment Intensities on Trunk Control of Stroke Patients: A Systematic Review, Meta-Analysis and Meta-Regression
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Abstrak
Kajian ini bertujuan untuk menilai keberkesanan intensiti rawatan latihan batang tubuh pada kawalan batang tubuh pesakit strok dengan skor Skala Kerosakan Batang Tubuh (TIS). Kajian kepustakaan berstruktur telah dilakukan dalam beberapa pangkalan data daripada artikel diindeks pertama sehingga Disember 2022, termasuk PubMed, Web of Science, PEDro, Perpustakaan Cochrane dan Scopus. Selain itu, pemilihan kajian telah disiasat mengikut garis panduan PRISMA. Hanya ujian terkawal rawak yang mengkaji keberkesanan latihan batang tubuh pada kawalan batang tubuh (diukur oleh TIS selepas strok) dimasukkan. Sebanyak 25 ujian dengan 976 pesakit strok telah dinilai. Sementara itu, tujuh kajian diklasifikasikan sebagai risiko berat sebelah yang tinggi. Tanpa mengira kaedah latihan dan kualiti kajian, kesan yang besar lebih berpihak kepada kumpulan latihan batang tubuh berbanding kumpulan kawalan. Analisis kepekaan mendedahkan kesan besar yang memihak kepada latihan batang tubuh pada kawalan batang tubuh [SMD = 1.16 (95% CI: 0.93-1.39); p<0.00001, I2 = 80%]. Selepas itu, tempoh rawatan latihan batang tubuh yang paling berkesan ialah 10 jam latihan kestabilan teras untuk penambahbaikan kawalan batang tubuh [SMD = 3.20 (95% CI: 2.25-4.15)]. Analisis meta-regresi tidak menunjukkan bukti kukuh intensiti rawatan latihan batang tubuh pada saiz kesan. Latihan batang tubuh adalah berkesan dalam pemulihan batang tubuh. Walau bagaimanapun, latihan batang tubuh tertentu diperlukan untuk fasa strok yang berbeza. Menariknya, saiz kesan telah diperbesarkan secara bermakna dengan menambah 15 minit latihan kestabilan teras kepada terapi konvensional (lima sesi seminggu selama lapan minggu campur tangan). Keputusan ini berguna dalam menentukan bilangan sesi untuk pemulihan batang tubuh yang berkesan.
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