Combined Effect of Sensory Training With Bobath Therapy in Patients With Chronic Stroke

Combined Effect of Sensory Training With Bobath Therapy on Proprioception, Balance, and Motor Function in Patients With Chronic Stroke

Chronic stroke causes moderate to severe impairments in proprioception, balance, and motor functions, which can impact upon an individual's ability to perform activities of daily living, leading to reduced quality of life and increased dependency. Proprioception, or detecting the body's position in open space, is important for balance and coordinated movement. One therapy uses traditional rehabilitation methods like Bobath theory to increase motor functions, aiming to utilize sensory and movement facilitation. Nonetheless, combining sensory and Bobath therapy could lead to superior outcomes by simultaneously addressing both the proprioceptive deficit and motor skills. The purpose of this project is to explore the combined effect of sensory training and Bobath therapy on proprioception, balance, andmotor function in chronic stroke survivors.

This randomized controlled trial study will take place at Ittefaq (Trust) Hospital, Lahore, with a sample size of 40 participants. Eligible participants will include individuals who are 6 months to 2 years old chronic stroke patients (age group 45 years to 60 years), possess a Mini-Mental State Examination (MMSE) score of 24 or higher, and can provide informed consent. Participants will be selected using nonprobability convenience sampling by using online randomizing tools. The participants will be randomly divided into groups (20 each). The study group will be subjected to combined sensory training and Bobath therapy. The duration of the intervention will be eight weeks, with three sessions per week aimed at improving proprioceptive awareness and motor function. Proprioception will be assessed using the proprioception assessment tool (PAT), joint position sense, and the Romberg test, while balance will be determined using the Berg Balance Scale. The Fugl-Meyer Assessment will be used to measure motor function. The first assessments will be the baseline assessments, done before the intervention, after which a follow-up will be done to measure the efficacy of the combined approach. Statistical analyses will be conducted to assess differences in outcomes between the two groups, helping to determine the effectiveness of combining sensory training with balance and motor function interventions in chronic stroke patients. The findings aim to contribute to the understanding of rehabilitation strategies for this population. Data analysis will be performed by using SPSS 26 software.

Inclusion Criteria:

• Both male and female included.
• Age group: 45 years to 60 years.
• Participants diagnosed with chronic stroke 6 months to 2 years.
• Mini-Mental State Examination (MMSE) score of 24 or higher.
• Cannot maintain balance for 30 seconds.
• Ambulate independently for 7 meters.

Exclusion Criteria:

• Participants having conditions other than chronic stroke (Parkinson's disease, Alzheimer's disease, orthopedic pathological condition, etc.).
• Participants having any visual, vestibular, or auditory impairment.
• Participants having any muscular injuries in the previous 6 months.
• Participants with a history of fracture in the previous 6 months.
• Participants with a history of mental illness.
• Participants with cardiovascular complications.