Cawthorne-Cooksey Exercises and Frenkel Exercises on Balance and Coordination in Stroke

Stroke, often caused by cerebral circulation disruption can lead to transient or permanent brain function deficit it is a leading cause of disability and death globally, with a particularly high burden in low- and middle-income countries like Pakistan. Balance and coordination impairments are common post-stroke, severely impacting patients' mobility and quality of life. While Cawthorne-Cooksey and Frenkel exercises are low-cost rehabilitation techniques known to aid balance and coordination, there is limited evidence comparing their effectiveness in stroke patients. This study aims to evaluate and compare the effects of Cawthorne-Cooksey and Frenkel exercises on improving balance and coordination in post-stroke patients. Specific goals include determining which protocol leads to faster and more sustained improvements and providing evidence-based recommendations for stroke rehabilitation.

Inclusion Criteria: * Adults aged 40-75 years * First-time ischemic or hemorrhagic stroke, diagnosed within the past 3-6 months (subacute phase) * Berg Balance Scale (BBS) score between 21-40 (indicating moderate balance impairment) * Ability to follow instructions (Mini-Mental State Exam score ≥ 24) * No previous participation in a rehabilitation program Exclusion Criteria: * History of multiple strokes or recurrent strokes * Individuals with a history of neurological deficits other than stroke, such as Parkinson's disease or multiple sclerosis * Severe musculoskeletal disorders, visual or auditory impairments * Any contraindications to start rehabilitation (i.e. severe uncontrolled hypertension, uncontrolled diabetes or unstable angina) * Use of assistive devices