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A stroke is characterized as a condition in which the brain's main arteries get clogged, reducing oxygen flow and potentially leading to death or severe disability. There are various types of strokes, such as transient ischemic attack (TIA), hemorrhagic stroke, and ischemic stroke. Hemorrhagic stroke is the most prevalent kind among them Strokes frequently alter postural balance. Balance is a complicated process that involves both static and dynamic elements. It significantly influences gait performance and community ambulation after strokes. Balance impairment is a common cause of falls in stroke survivors.
Post-stroke recovery is related to loss of control of one's body posture, uneven weight distribution, and lack of anticipatory and reactive balance, which hinder movement in the community and severely affect one's quality of life. The loss of balance is one of the major problems that stroke patients have to deal with and is considered the most serious part of the illness. Medically, it is characterized as the result of multiple factors such as: i) damage to brain areas responsible for processing vestibular input, ii) blockage for proprioceptive feedback, iii) poor coordination among the different brain regions involved in motor planning and execution and visual feedback. These factors, in turn, and together, block the person's body from moving stably during static and dynamic activities. More than 70% of stroke patients develop significant balance problems within the first year of the stroke and such problems, besides other factors, are the reason for the high occurrence of falls among them. Reports indicate that the fall rate in the stroke population is more than double that in the non-disabled elderly.
A stroke is categorized by a local neurological deficiency that progresses suddenly and persists longer than twenty-four hours, which led to death before time . Stroke, the disruption of blood supply to the brain, remains the top cause of debility that lasts for long time, creating considerable socioeconomic and healthcare issues all over the world. The ads need to show that this condition can sometimes lead to serious cases where the person is not able to control or feel anything, is not able to balance, or walk, and is not functioning independently. Over the last few years, research has shown that each year there are more than 12 million new strokes all over the world and many people who have survived stroke undergo through a long process of rehabilitation whereby they are only taught how to get back to functioning more or less and at the same time to be less prone to falling.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Wobble Board Exercises | Active Comparator | Exercises:
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| Swiss Ball Exercises | Experimental | Seated Balance: Sitting on Swiss ball to activate the core without overstressing spastic or weak muscles.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Wobble Board Exercises | Other | Duration: 10 minutes per session Frequency: 3 sessions per week Objective: Establish foundational balance in standing for mild-to-moderate spasticity levels. Exercises:
Duration: 25 minutes per session Frequency: 3 sessions per week Objective: Gradual increase in static balance exercises to enhance postural control without exceeding tolerance levels. Exercises:
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| Measure | Description | Time Frame |
|---|---|---|
| (FSST) Four-Square Step Test | The Four-Square Step Test (FSST) is a dynamic evaluation tool for balance and coordination in which participants step forward, sideways, and backward over four canes set in a cross pattern. Score is determined by the time that it takes to finish; two trials are made, and the best time is noted. Research has confirmed its reproducibility and validity, such as musculoskeletal problems, neurological illnesses, and elderly adults. With a cut-off period of 15 seconds, it accurately detects fall risk, with older persons having a larger chance of falling | 2 to 4 mins |
| Berg Balance Scale (BBS) | An instrument that is frequently used to evaluate an adult's balance and fall risk is the Berg Balance Scale (BBS). It has 14 tasks with a maximum score of 56, and each activity is rated on a scale of 0 to 4. Improved balance is indicated by higher scores. Low fall risk is indicated by scores 41-56, medium fall risk by scores 21-40, and high fall risk by scores 0-20. Particularly in stroke rehabilitation, it predicts functional results and correlates well with other balance measures | 2 to 4 mins |
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Inclusion Criteria:
Exclusion Criteria
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Imran Amjad, PhD | Contact | 03324390125 | imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Sobia Kanwal, tDPT | Riphah International University | Principal Investigator |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Swiss Ball Exercises | Other | Duration: 10 minutes per session Frequency: 3 sessions per week Objective: Build initial seated balance and core activation on the Swiss ball. Exercises:
Exercises:
Duration: 30 minutes per session |
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| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |