Chronic Stroke Patient
Conditions
Keywords
Chronic Stroke, Swiss Ball Exercises, Kinesthetic Training, Balance Training
Brief summary
Stroke is one of the leading causes of long-term disability and commonly results in impaired balance, reduced trunk control, and difficulty in functional mobility. Chronic stroke patients often experience limitations in daily activities due to poor postural stability and decreased motor coordination. Various rehabilitation approaches are used to improve balance and mobility, among which Swiss ball exercises and kinesthetic training are considered beneficial interventions. The purpose of this randomized controlled trial is to compare the effectiveness of Swiss ball exercises versus kinesthetic training in improving balance and functional mobility in patients with chronic stroke. A total of 36 participants diagnosed with chronic stroke for more than six months will be recruited and randomly allocated into two groups. Group A will receive Swiss ball exercises focusing on trunk stability, coordination, and balance control, while Group B will receive kinesthetic training aimed at improving proprioception, sensory feedback, and motor control. The intervention program will continue for 8 weeks under the supervision of qualified physiotherapists in the Physiotherapy Department of Shalimar Health Centre. Balance and functional mobility will be assessed before and after the intervention using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. This study aims to determine which intervention is more effective in enhancing balance and mobility in chronic stroke patients and may help improve rehabilitation strategies for stroke recovery.
Detailed description
Stroke commonly leads to long-term physical impairments including poor balance, impaired proprioception, decreased trunk stability, and reduced functional mobility. These deficits negatively affect independence in activities of daily living and increase the risk of falls in chronic stroke patients. Rehabilitation strategies focusing on balance retraining and motor control are essential for improving functional outcomes and quality of life. Swiss ball exercises are widely used in neurorehabilitation to improve trunk control, postural stability, coordination, and balance through unstable surface training. These exercises stimulate core muscle activation and enhance neuromuscular control during functional movements. On the other hand, kinesthetic training focuses on proprioceptive input, sensory feedback, motor relearning, and coordinated movement patterns to improve postural control and mobility. Although both treatment approaches have shown beneficial effects in stroke rehabilitation, limited evidence is available comparing their effectiveness specifically in chronic stroke patients. Therefore, this randomized controlled trial aims to compare the efficacy of Swiss ball exercises and kinesthetic training in improving balance and functional mobility among individuals with chronic stroke. A total of 36 participants meeting the eligibility criteria will be recruited from the Physiotherapy Department of Shalimar Health Centre. Participants will be randomly allocated into two equal groups using computerized randomization. Group A will receive a structured Swiss ball exercise program, while Group B will receive kinesthetic training exercises. Both intervention protocols will be supervised by qualified physiotherapists and conducted for 8 weeks. Outcome measures will include the Berg Balance Scale (BBS) for assessment of balance and the Timed Up and Go (TUG) test for assessment of functional mobility. Measurements will be recorded at baseline and after completion of the intervention period. Data collection will be performed by an assessor blinded to group allocation to minimize assessment bias. The findings of this study may provide evidence regarding the comparative effectiveness of Swiss ball exercises and kinesthetic training and may assist physiotherapists in selecting appropriate rehabilitation interventions for chronic stroke patients.
Interventions
BEHAVIORALSwiss Ball Exercise Training
Participants assigned to this intervention will perform a progressive Swiss ball exercise program aimed at improving trunk stability, postural control, balance, coordination, and functional mobility in chronic stroke patients. The intervention includes sitting balance activities, pelvic tilts, bridging exercises, dynamic reaching tasks, weight-shifting activities, wall squats, and gait-related exercises using a Swiss ball. Exercises will be supervised by qualified physiotherapists and performed over an 8-week treatment period with gradual progression in difficulty.
BEHAVIORALKinesthetic Training
Participants assigned to this intervention will receive kinesthetic training focused on improving proprioception, sensory feedback, postural stability, motor control, and functional mobility. The program includes static and dynamic balance activities, weight-shifting exercises, tandem standing, gait training, obstacle navigation, dual-task activities, and proprioceptive exercises performed under physiotherapist supervision. The intervention will be conducted progressively over 8 weeks according to participant performance and tolerance.
Sponsors
Nisha Fazal
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Patients diagnosed with stroke for past 6 or more then 6 months both sides (R, L). Age: 45-65 years . Absence of cognitive impairment ( Mini Mental State Examination Score \>23). Able to follow 3 step command. Medically stable. Both genders. Who can manage to come to the medical centre. Who score 21-50 on berg balance scale (BBS). Able to participate in the exercise program. Who don't have any cardiovascular or musculoskeletal problem.
Exclusion criteria
Cognitive impairment hindering performance. Other neurological problems. Acute or subacute stroke. Impair vision without correction. Other health problem ( cardiovascular, DM etc). Pain during standing or walking. Lake the ability to participate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Berg Balance Scale (BBS) | Baseline (Week 0) and post-intervention after 6 weeks of treatment | The Berg Balance Scale (BBS) will be used to assess static and dynamic balance in chronic stroke patients. It consists of 14 functional tasks such as sitting, standing, turning, and reaching activities. Each item is scored from 0 to 4, with a maximum total score of 56. Higher scores indicate better balance and lower risk of falls. The BBS is a reliable and validated tool widely used in stroke rehabilitation to evaluate postural control and functional balance. |
Countries
Pakistan
Contacts
CONTACTNisha Fazal, MSPTN
CONTACTMontiha Azeem, MSPTN
PRINCIPAL_INVESTIGATORNisha Fazal, MSPTN
The University of Lahore, Lahore
Outcome results
None listed