This research explores the combined effects of motor imagery and core stability exercises on trunk control, balance, and sleep quality in stroke recovery, addressing Pakistan's unique healthcare challenges. By enhancing neuroplasticity, core strength, and physical function, these interventions aim to improve mobility, independence, and overall quality of life for stroke survivors, while addressing common sleep disturbances.

Stroke patients can benefit from motor imagery and mirror therapy, which are easy to perform anytime and anywhere at their convenience. Integrating motor imagery training with task-specific training leads to greater improvements in sit-to-stand performance compared to task-specific training alone. Core exercises, whether performed alone or combined with other therapies, have been shown to influence trunk performance in stroke patients compared to traditional training. Patients who have had strokes can benefit from rehabilitation training that focuses on strengthening their core muscles. This is likely because it thickens the transverse abdominis muscle. Post-stroke patients were able to regain their motor function and sense of independence with the use of motor imagery as an additional resource. It has been shown to be an effective therapeutic strategy for this particular patient population. More than with routine physiotherapy, core stability exercises on both stable and unstable support surfaces improve ambulatory stroke patients' trunk control, core muscular strength, standing weight-bearing symmetry, and balance confidence. Combined action observation and motor imagery therapy may be helpful for neurorehabilitation in chronic stroke survivors when physical practice is not appropriate. Compared to standard physical treatment alone, core stability exercise and conventional physical therapy has demonstrated better outcomes in trunk control and balance.

The combination of motor imagery and core stability exercises remains underexplored in stroke rehabilitation, leaving a significant knowledge gap about their synergistic potential. Investigating their combined effects could offer innovative strategies to improve trunk control, balance, and sleep quality, paving the way for more comprehensive and effective post-stroke treatment programs.

Inclusion Criteria: Adults aged 40-65 years.

• Diagnosed with stroke (ischemic or hemorrhagic) within the last 6 months to 2 years.
• Hemiplegic Patient
• Having MMSE score ≥ 24
• Experiencing balance impairments on BBS 21-40
• Having sleep disturbances on PSQI 15-21.
• Willing to provide informed consent.

Exclusion Criteria: Severe cognitive impairments (e.g., severe dementia).

• Other neurological or musculoskeletal conditions affecting balance.
• Severe cardiovascular or respiratory conditions contraindicating exercise.
• Participation in another clinical trial within the past 3 months.