Core Stability Exercises Improves Functional Outcomes in Early Stroke Recovery. A Randomized Controlled Trial

Background: Core stability exercise (CSE) as a means of improving trunk performance, dynamic sitting balance, and gait has become increasingly popular in recent years. The aim of this study was to assess, for post-stroke patients, the eff of CSE in addition to conventional physiotherapy (CP) versus CP alone in terms of functional outcomes at the end of the intervention and 12 weeks later. Methods: CORE is a multicentre, parallel, randomized, controlled, assessor-blinded trial. The intervention, started in the early stroke recovery stage (≤30 days), consisted of CSE (30 minutes) plus CP (30 minutes) or CP alone (60 minutes), for 5 days weekly over 5 weeks. Primary outcomes were dynamic sitting balance, trunk coordination (Spanish-Trunk Impairment Scale 2.0; S-TIS 2.0) and stepping (gait) (Brunel Balance Assessment (BBA) steeping section). Secondary outcomes were postural control (Spanish Postural Assessment Scale), balance ability and fall risk (Berg Balance Scale), lower limb spasticity (Modified Ashworth Scale), activities of daily living (Barthel Index and Modified Rankin Scale), quality of life (EuroQoL 5-Dimension 5-Level questionnaire), and health status (EuroQoL 5-Dimension questionnaire). Outcomes were assessed at the end of intervention (5 weeks) as the primary end-point. Results: Of 87 recruited patients, 83 were assessable: 40 (48.3%) in the CSE group and 43 (51.7%) in the control group. Results (mean difference) favoured CSE regarding dynamic sitting balance, trunk coordination, and S-TIS 2.0 total score. No differences were observed for BBA gait. With CSE, lower limb spasticity was reduced and quality of life (total score) was improved.