All stroke patients were assessed via isokinetic dynamometer, Montreal cognitive assessment scale (MOCA) and Fugl Myer Upper extremity (FMUE) before and after the treatment program.

The patients were classified randomly into three equal groups, Study group A (GA) receiving modified constraint induced movement therapy in addition to conventional physical therapy program, Study group B (GB) receiving dual task training in addition to conventional physical therapy program and control group C (GC) receiving only conventional physiotherapy program.

Inclusion Criteria:

• Patients with age range between 55 and 65 years old.
• The patients were from both genders (males &females).
• Patients were of duration of illness between 6 and 12 months.
• The patients were scoring 1 &1+ on modified Ashworth scale (mild spasticity).
• The patients were of good ability to see and hear.
• Consent form was obtained from all participants to approve the study and follow the commands.
• All patients were scoring more than 26 on MMSE. All patients were medically stable.

Exclusion Criteria:

• patients with moderate and sever spasticity.
• patients with cognitive disorder due to other cause rather than spasticity.
• patients with unstable medical conditions.
• patients with previous or recurrent stroke.
• patients with respiratory problems.
• patients with shoulder dislocation or subluxation or frozen shoulder.
• patients with uncontrolled hypertension, diabetes mellitus, unstable angina or heart failure.

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