This randomized clinical trial will be conducted at various physical therapy clinics of Faisalabad over a six-month period, enrolling a total of 32 participants selected through non probability convenience sampling technique. Participants will be randomly assigned to one of two groups: those undergoing Neuropilates and those performing Otago exercises, with each group consisting of 16 individuals. Assessments will utilize the TUG (Timed Up and Go) to evaluate balance, the Postural Assessment Scale for Stroke Patients (PASS) for posture, and the Functional Independence Measure (FIM) for functional independence. Pre-intervention assessments will establish baseline measures, followed by evaluations at 4 weeks, and post-intervention to track progress. Data analysis will be conducted using SPSS 26 software, allowing for a comprehensive comparison of the interventions' effectiveness. The findings from this study will contribute valuable insights for clinicians and rehabilitation specialists, enhancing therapeutic strategies to support chronic stroke patients in regaining their independence.

Chronic stroke survivors often face profound challenges that considerably impact their balance, posture, and functional independence. These issues can compromise their ability to perform daily activities, reduce their quality of life, and lead to increased dependency on caregivers. Effective rehabilitation strategies are essential for improving these aspects of recovery. Neuropilates, a novel approach that merges the foundational principles of Pilates with targeted neurological rehabilitation techniques, has shown promise in enhancing physical and cognitive function. By focusing on core strength, flexibility, and body awareness, Neuropilates aims to facilitate motor learning and improve overall stability. This study is designed to compare the effectiveness of Neuropilates with Otago exercises-an evidence-based program specifically designed to enhance strength and balance in older adults-on key rehabilitation outcomes for individuals living with chronic stroke. The Otago program emphasizes lower limb strength and balance training, making it a relevant comparison for assessing improvements in functionality.

The randomized clinical trial will be conducted at various physical therapy clinics of Faisalabad over a six-month period, enrolling a total of 32 participants selected through non probability convenience sampling technique. Participants will be randomly assigned to one of two groups: those undergoing Neuropilates and those performing Otago exercises, with each group consisting of 16 individuals. Assessments will utilize the TUG (Timed Up and Go) to evaluate balance, the Postural Assessment Scale for Stroke Patients (PASS) for posture, and the Functional Independence Measure (FIM) for functional independence. Pre-intervention assessments will establish baseline measures, followed by evaluations at 4 weeks, and post-intervention to track progress. Data analysis will be conducted using SPSS 26 software, allowing for a comprehensive comparison of the interventions' effectiveness. The findings from this study will contribute valuable insights for clinicians and rehabilitation specialists, enhancing therapeutic strategies to support chronic stroke patients in regaining their independence.

Inclusion Criteria:

• Age 40-70 years
• Both male and female
• Chronic stroke, 6-18 months post-stroke
• Stroke severity score >6 on NIHSS
• MMSE ≥24

Exclusion Criteria:

• • Symptoms of global or receptive aphasia

  • Other neurological disorders: tumors, anoxia, TBI, neurodegenerative diseases, ataxia.
  • Significant cardiorespiratory conditions
  • Currently receiving other complementary interventions
  • Severe motor impairment preventing safe participation