Exercise therapy can effectively improve trunk performance and sitting balance in spinal cord injury: a systematic review and meta-analysis

To determine the effects of exercise on trunk performance and balance in patients with spinal cord injury (SCI).

We searched the databases MEDLINE, Cochrane Library, EMBASE, Physiotherapy Evidence Database, Web of Science, PsycINFO, and CINAHL from inception to June 2020. Our search targeted studies such as randomized or non-randomized controlled trials and randomized crossover trials that evaluated the effects of exercise on trunk performance and balance in patients with SCI.

Seventeen eligible studies with 432 patients with SCI were included in the meta-analysis. The exercise significantly improved several measures: Berg Balance Scale (mean differences [MD] = 4.58; 95% confidence intervals [CI], 0.35, 8.8; p = 0.03), Modified Functional Reach Test (MD = 5.29; 95% CI, 4.16, 6.42; p < 0.01), T-shirt test (MD = 5.62; 95% CI, − 3.82, − 7.42; p < 0.01), Timed Up and Go (MD = − 1.70; 95% CI, − 0.23, − 3.16; p = 0.02). Improvements were also noted in total static sitting balance (standardized mean differences [SMD] = 1.21; 95% CI, 0.79, 1.63; p < 0.01), and total dynamic sitting balance (SMD = 1.01; 95% CI, 0.30, 1.73; p < 0.01). In the subgroup analysis, exercise with sensory input enhancement significantly improved total static (SMD = 1.37; 95% CI, 0.64, 2.11; p < 0.01) and total dynamic sitting balance (SMD = 1.78; 95% CI, 0.28, 3.29; p = 0.02).

Exercise may improve sitting balance in patients with SCI. Moreover, enhancement of sensory input had an add-on effect in improving sitting balance.

Registration: PROSPERO (CRD42020185904).