This study aims to investigate the effect of adding augmented cues to conventional physical therapy intervention on hand function in patients with post-stroke hemiparesis. Fifty patients with subacute ischemic stroke will be randomly assigned to either a study group receiving augmented cue-based training in addition to conventional physical therapy or a control group receiving conventional physical therapy alone. Hand function will be assessed before and after the intervention period using the Nine-Hole Peg Test (NHPT), hand grip strength measured by a dynamometer, and pressure pain threshold measured by a pressure algometer. The findings of this study may provide evidence regarding the effectiveness of augmented cue-based rehabilitation strategies in improving hand function after stroke.

Stroke is one of the leading causes of long-term disability worldwide and frequently results in impaired hand function, reduced dexterity, decreased grip strength, and limitations in activities of daily living. Conventional physical therapy is commonly used to improve upper extremity function; however, recovery of hand performance remains challenging for many stroke survivors.

Augmented cues provide additional sensory information through visual, auditory, or sensorimotor feedback that may enhance motor learning and neuroplasticity. Incorporating augmented cues into rehabilitation programs may improve patient engagement, increase repetition of task-specific movements, and facilitate functional recovery.

The purpose of this randomized controlled trial is to examine the effectiveness of adding augmented cue-based training to conventional physical therapy intervention in improving hand function among patients with subacute ischemic stroke.

A total of 50 participants meeting the eligibility criteria will be recruited and randomly assigned into two equal groups:

Study Group: Participants will receive augmented cue-based training combined with conventional physical therapy.

Control Group: Participants will receive conventional physical therapy only.

The intervention will be conducted over an eight-week treatment period. Outcome measures will be collected before and after treatment and will include:

1. Nine-Hole Peg Test (NHPT) to assess manual dexterity.
2. Hand grip strength measured using a hand dynamometer.
3. Pressure pain threshold measured using a pressure algometer.

The primary objective is to determine whether the addition of augmented cues results in greater improvement in hand function compared with conventional physical therapy alone. The results may contribute to the development of more effective rehabilitation strategies for individuals recovering from stroke.

Inclusion Criteria:

• - Male and female patients.
• Age between 40 and 60 years.
• First-ever subacute ischemic stroke.
• Time since stroke between 6 weeks and 6 months.
• Unilateral upper limb involvement.
• Able to understand and follow verbal instructions.
• Medically stable and able to participate in the rehabilitation program.
• Willing to provide informed consent.

Exclusion Criteria:

• - Hemorrhagic stroke.
• Bilateral stroke involvement.
• Severe cognitive impairment or severe aphasia interfering with participation.
• Severe visual or auditory deficits affecting training.
• Severe upper limb spasticity that prevents hand training.
• Other neurological disorders affecting upper limb function.
• Severe musculoskeletal disorders of the upper limb.
• Participation in another rehabilitation trial during the study period.
• Unstable cardiovascular or medical conditions.

Individual participant data (IPD) will be available from the corresponding author upon reasonable request.