Effectiveness Of Core Stability Exercises In Improving Dynamic Sitting Balance In Post-Stroke Cases

Authors

  • Anuska Baliarsingh
  • Ashisha Ksirabdhi Tanaya(PT)
  • SK. Jahangir
  • Ayaskanta Acharya
  • Soumya Ranjan Pattnaik
  • Manjusha Ambatkar

DOI:

https://doi.org/10.63682/jns.v14i33S.9777

Keywords:

Stroke Rehabilitation, Core Stability Exercise, Dynamic sitting balance, Trunk control, Trunk Impairment Scale (TIS)

Abstract

Background: Dynamic sitting balance is a significant early indicator of mobility and independence after stroke, but trunk control is usually disturbed. Core stability exercises (CSEs) could be used to enhance postural control in this population.

Objective: To determine the effectiveness of CSEs in improving dynamic sitting balance in adults after stroke.

Methods: A randomized controlled trial in a tertiary center in Bhubaneswar involving 60 patients (45–75 years) who were randomized into CSE + routine physiotherapy (Group A) or routine physiotherapy alone (Group B). The most significant inclusion criteria were first-ever unilateral stroke in the past year, sitting ability ≥10 s, and baseline Trunk Impairment Scale (TIS) ≤10. Primary measures were TIS and an age-predicted sitting balance scale, both of which were measured at baseline and 3 months. Sessions were delivered 5 days/week for 45–60 minutes; CSEs targeted deep and global trunk stabilizers with increasing difficulty.

Result: Both conditions exhibited important improvement in Trunk Impairment Scale (TIS) scores (p<0.001). The experimental condition improved from 7.37 ± 1.71 to 13.43 ± 2.06, while the control condition improved from 7.50 ± 1.94 to 12.10 ± 2.19. Between-group comparison revealed a significant difference in the experimental group's favor (t=4.303, p<0.001). The findings reveal that the experimental treatment induced greater improvement in sitting balance and trunk control compared to routine therapy.

Conclusion: The integration of a systematic CSE program with routine physiotherapy results in clinically and statistically improved gains in post-stroke trunk control and dynamic sitting balance. CSEs are simple, low-cost, and can be integrated into routine rehabilitation procedures

Downloads

Download data is not yet available.

References

1. Bhat R, Shanbhag P. Knowledge, Attitude, and Practice Study on Cardiovascular Disease Risk Factors in the Mangalore Community. Oral Sphere J. Dent. Health Sci. 2025;1(1):19-28. doi: 10.63150/osjdhs.2025.32

2. Tyson, S.F.; Hanley, M.; Chillala, J.; Selley, A.; Tallis, R.C. Balance Disability After Stroke. Phys. Ther. 2006.

3. Gadidi, V.; Katz-Leurer, M.; Carmeli, E.; Bornstein, N.M. Long-Term Outcome Poststroke: Predictors of Activity Limitation and Participation Restriction. Arch. Phys. Med. Rehabil. 2011.

4. Oliveira, C.B.; Medeiros, Í.R.T.; Greters, M.G.; Frota, N.A.F.; Lucato, L.; Scaff, M.; Conforto, A. Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke. Clinics 2011.

5. Isho, T.; Usuda, S. Association of trunk control with mobility performance and accelerometry-based gait characteristics in hemiparetic patients with subacute stroke. Gait Posture 2016.

6. Schmid, A.A.; Rittman, M. Consequences of Poststroke Falls: Activity Limitation, Increased Dependence, and the Development of Fear of Falling. Am. J. Occup. Ther. 2009 .

7. Galeoto, G.; Iori, F.; De Santis, R.; Santilli, V.; Mollica, R.; Marquez, M.A.; Sansoni, J.; Berardi, A. The outcome measures for loss of functionality in the activities of daily living of adults after stroke: A systematic review. Top. Stroke Rehabil. 2019 .

8. Pouwels, S.; Lalmohamed, A.; Leufkens, B.; de Boer, A.; Cooper, C.; van Staa, T.; de Vries, F. Risk of hip/femur fracture after stroke: A population-based case-control study. Stroke 2009 .

9. Lozano, R.; Naghavi, M.; Foreman, K.; Lim, S.; Shibuya, K.; Aboyans, V.; Abraham, J.; Adair, T.; Aggarwal, R.; Ahn, S.Y.; et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012 .

10. Park, J.; Yoo, I. Relationships of Stroke Patients’ Gait Parameters with Fear of Falling. J. Phys. Ther. Sci. 2014 .

11. Kim, E.J.; Kim, D.Y.; Kim, W.H.; Lee, K.L.; Yoon, Y.H.; Park, J.M.; Shin, J.I.; Kim, S.K.; Kim, D.G. Fear of Falling in Subacute Hemiplegic Stroke Patients: Associating Factors and Correlations with Quality of Life. Ann. Rehabil. Med. 2012.

12. Barra, J.; Marquer, A.; Joassin, R.; Reymond, C.; Metge, L.; Chauvineau, V.; Pérennou, D. Humans use internal models to construct and update a sense of verticality. Brain 2010.

13. Ryerson, S.; Byl, N.N.; Brown, D.A.; Wong, R.A.; Hidler, J.M. Altered Trunk Position Sense and Its Relation to Balance Functions in People Post-Stroke. J. Neurol. Phys. Ther. 2008 .

14. Van Nes, I.J.; Nienhuis, B.; Latour, H.; Geurts, A.C. Posturographic assessment of sitting balance recovery in the subacute phase of stroke. Gait Posture 2008 .

15. Harbourne, R.T.; Lobo, M.A.; Karst, G.M.; Galloway, J.C. Sit happens: Does sitting development perturb reaching development, or vice versa? Infant Behav. Dev. 2013 .

16. Hara, Y. Brain Plasticity and Rehabilitation in Stroke Patients. J. Nippon Med. Sch. 2015 .

17. Coleman, E.R.; Moudgal, R.; Lang, K.; Hyacinth, H.I.; Awosika, O.O.; Kissela, B.M.; Feng, W. Early Rehabilitation After Stroke: A Narrative Review. Curr. Atheroscler. Rep. 2017 .

18. Cassidy, J.; Cramer, S.C. Spontaneous and Therapeutic-Induced Mechanisms of Functional Recovery After Stroke. Transl. Stroke Res. 2017.

19. Regenhardt, R.; Takase, H.; Lo, E.H.; Lin, D.J. Translating concepts of neural repair after stroke: Structural and functional targets for recovery. Restor. Neurol. Neurosci. 2020.

20. Lee, K.B.; Lim, S.H.; Kim, K.H.; Kim, K.J.; Kim, Y.R.; Chang, W.N.; Yeom, J.W.; Kim, Y.D.; Hwang, B.Y. Six-month functional recovery of stroke patients. Int. J. Rehabil. Res. 2015.

21. Pollock, A.; Baer, G.; Campbell, P.; Choo, P.L.; Forster, A.; Morris, J.; Pomeroy, V.M.; Langhorne, P. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst. Rev. 2014.

22. Cabanas-Valdés, R.; Cuchi, G.U.; Bagur-Calafat, C. Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: A systematic review. Neurorehabilitation 2013.

23. Van Criekinge, T.; Truijen, S.; Schröder, J.; Maebe, Z.; Blanckaert, K.; Van Der Waal, C.; Vink, M.; Saeys, W. 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.

24. Cabanas-Valdés, R.; Bagur-Calafat, C.; Girabent-Farrés, M.; Caballero-Gómez, F.M.; Hernández-Valiño, M.; Cuchí, G.U. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: A randomized controlled trial. Clin. Rehabil. 2016.

25. Szafraniec, R.; Barańska, J.; Kuczyński, M. Acute effects of core stability exercises on balance control. Acta Bioeng Biomech 2018.

26. Haruyama, K.; Kawakami, M.; Otsuka, Effect of Core Stability Training on Trunk Function, Standing Balance, and Mobility in Stroke Patients. Neurorehabilit. Neural Repair 2016.

Books

1. Susan B. O’Sullivan, Thomas J. Schmitz, Gorge Fulk, Physical Rehabilitation

Darcy A. Umphred, Rolando T. Lazaro, Umphred’s Neurological Rehabilitation.

Downloads

Published

2025-12-27

How to Cite

1.
Baliarsingh A, Ksirabdhi Tanaya(PT) A, Jahangir S, Acharya A, Ranjan Pattnaik S, Ambatkar M. Effectiveness Of Core Stability Exercises In Improving Dynamic Sitting Balance In Post-Stroke Cases. J Neonatal Surg [Internet]. 2025 Dec. 27 [cited 2026 Jan. 20];14(33S):213-2. Available from: https://jneonatalsurg.com/index.php/jns/article/view/9777