The purpose of the present study is to investigate the effect of pilates training on cognitive functions in patient with stroke

Stroke remains a primary cause of morbidity throughout the world mainly because of its effect on cognition. Individuals can recover from physical disability resulting from stroke, but might be unable to return to their previous occupations or independent life because of cognitive impairments.

Post-stroke cognitive impairment is not a unitary syndrome but incorporates a variety of deficits in multiple domains such as attention, executive functions , memory, language and visuoperceptual abilities. Cognitive impairment occurs in up to 64% of people who have had a stroke and has been associated with a 3-fold increase in risk for mortality, institutionalization and decreased instrumental activities of daily living function.

Pilates training was developed by Joseph H. Pilates .It belong to a group of so-called Body-Mind Exercises, where the focus is on controlled movement, posture, and breathing .Pilates (pronounced: puh-lah-teez) improves mental and physical well-being , increases flexibility through controlled movements done as mat exercises.

Pilates training improve cognitive functions through increasing blood and oxygen flow to the brain , support neuronal survival in the developping brain ,Generate new neurons ,Provides mood enhancement ,Increases neurotransmitters and Neurotrophins assure the survival of neurons in areas responsible for learning, memory and higher thinking.

Inclusion Criteria:

1. Forty patients with stroke (hemiparesis) with muscle power at least grade 3 according to manual muscle testing scale (Appendix VI) from both genders their ages will be ranged from 50-65years old.
2. Patients with ischaemic stroke in the domain of the carotid system.
3. All patients have mild cognitive deficits in domains ( memory, attention, orientation, perception and executive skills) with score <25 according to Montreal Cognitive Assessment (Appendix IV).
4. Duration of illness not less than six months and not more than 18 months.
5. Spastcity grade (1) according to the Modified aschworth scale (MAS) ( Bohannon and Smith, 1987)(Appendix III).
6. All patients in the study should be ambulant independently.
7. Medically and psychologically stable patients.
8. All patients will approve and sign a consent form (Appendix I).
9. All patients are litrate.

Exclusion Criteria:

1. Patients with hemiparesis with motor weakness or incoordination.
2. Patients with cardiovascular problems (uncontrolled hypertension ,unstable angina ,significant coronary heart disease and or congestive heart failure).
3. Patients with dementia with score <3 according to Mini cog test(Appendix V). .
4. Patients with Musculoskeletal problems (deformity or contracture).
5. Medically unstable and uncooperative patients.
6. Patients with Moderate and severe obesity (BMI≥ 35 kg/m2).
7. Patients with depression with score > 8 according to Hamilton depression rating scale (HAM-D) (Appendix VII).