Objective: To investigate the effects of sling exercise training (SET) emphasizing core muscle control on gait performance in people with chronic stroke.

Background: Balance and gait performance are often impaired in people post-stroke. Evidence showed positive correlations between trunk control and balance and walking ability [1]. SET has been suggested to improve core muscle stability and strength including people with stroke [2]. Previous studies applying core muscle training reported positive effects on improving trunk control and sitting balance among people with chronic stroke. However, benefits on standing balance and gait performance remained undetermined [3]. Hence, present study aims to examine effects of SET on balance and gait performance in people with stroke.

Method: Nine participants with chronic stroke were recruited and randomly assigned to one of the two groups, SET (n=5) and conventional balance training (n=4) group. Each intervention is 30 minutes per session, with a total of 12 sessions over 4 to 6 weeks. The outcomes were measured before and after completing the intervention and at one-month follow-up, including gait performance, balance and trunk performance.

Results: Gait speed, stride length, spatial symmetry index, index of limits of stability (LOS) test to unaffected side, and trunk extensor strength  improved significantly after SET (p=.042-.043). At follow-up, SET group showed significant improvements in step length and single support time  of unaffected leg (p=.043), complete time of LOS (p=.043), overall index of LOS (p=.042), and indices of LOS to forward, unaffected side, and backward/unaffected side (p=.042-.043). Significant group differences were found in stability index of anterior-posterior direction of affected leg after intervention and at follow-up (p=.016), and complete time of LOS at follow-up (p=.016). In trunk performance, significant group difference was detected in trunk extensor strength at the post-test (p=.016).

Conclusion: Our preliminary results show the 12-session SET is more effective on improving trunk extensors strength than the control group. Besides, the gait performance improved significantly after SET and balance performance improved at follow-up in people with chronic stroke. We also note the improvements in stability indices of affected leg stance which seems to be training-specific or learning effect in the control group.

References: 1. Kim, J. H., Lee, S. M., & Jeon, S. H. (2015). Correlations among trunk impairment, functional performance, and muscle activity during forward reaching tasks in patients with chronic stroke. Journal of physical therapy science, 27(9), 2955–2958.
2. Lee, J. S., & Lee, H. G. (2014). Effects of sling exercise therapy on trunk muscle activation and balance in chronic hemiplegic patients. Journal of physical therapy science, 26(5), 655–659.
3. Cabanas-Valdés, R., Cuchi, G. U., & Bagur-Calafat, C. (2013). Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: a systematic review. NeuroRehabilitation, 33(4), 575–592.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-sling-exercise-in-people-with-chronic-stroke-the-emphasis-of-core-muscle-control-on-gait/