Adding trunk-oriented exercises, in addition to conventional exercises, may improve trunk control as well as arm and respiratory function in children with Duchenne muscular dystrophy (DMD), according to a study from Turkish researchers published in Clinical Rehabilitation.

Adding trunk exercises to a conventional exercise program for 8 weeks led to significant differences in Trunk Control Measurement Scale scores (P <.01), arm function scores (P <.01), and respiratory function values (ranging from P <.01 to P <.05) compared to a control group that performed only conventional exercises.

After 8 weeks, the study group showed improvements in all evaluated parameters except for shoulder-level and middle-level scores on the Performance of Upper Limb Scale. In contrast, the control group showed no differences in Trunk Control Measurement Scale scores, Performance of Upper Limb Scale scores, or peak expiratory flow volume, as well as a decline in forced vital capacity and forced expiratory volume.

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In intergroup comparisons of the parameters, the Trunk Control Measurement Scale, Performance of Upper Limb Scale total, forced vital capacity %, forced expiratory volume in 1 second %, and Performance of Upper Limb Scale distal test all had strong effect sizes (d >.8) as measured by Cohen’s d coefficient.

“Our study revealed the trunk-oriented exercises may be effective in improving the functional level of children with Duchenne muscular dystrophy, and trunk assessment may be added to the general assessment of the patient from the early period of the disease,” the authors concluded.

In the study, 26 children with DMD were recruited and divided into a treatment group (n=13) and a control group (n=13). The patients’ scores on trunk, upper limb, and respiratory function tests were recorded at baseline and after 8 weeks of exercise. Patients in the control group followed a conventional exercise program twice a day that included stretching and active or active-assisted strength exercises for the upper extremity, lower extremity, abdominal muscles, and back muscles. 

The study group also performed the conventional exercise program but substituted a trunk-oriented exercise program for their usual exercise session twice a week. The trunk-oriented exercise program also consisted of stretching exercises but additionally included stabilization exercises, trunk mobilization, and functional reaching exercises.


Güneş Gencer GY, Yilmaz Ö. The effect of trunk training on trunk control, upper extremity, and pulmonary function in children with Duchenne muscular dystrophy: a randomized clinical trial. Clin Rehabil. Published online September 2, 2021. doi:10.1177/02692155211043265