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

Summary

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.

Conditions

• Stroke
• Stroke (CVA) or TIA
• Balance
• Coordination Impairment

Interventions

OTHER

Cawthorne-Cooksey Exercises

Warm up like ankle pumping and circles will be performed before starting the session for 5- 10 minutes. Cool down exercises like deep breathing will be performed for 5-10 minutes after intervention. A. In Supine Lying 1. Eye movements: at first slow, then quick. * Up and down. * From side to side. * Focus on finger moving from 3ft to 1ft away from face. 15 2. Head movements: at first slow, then quick. Later with eyes closed. * Bend backwards and forwards. * Turn from side to side. B. Sitting * 1 and 2 - as above * Shoulder shrugging and circling * Bend forward and pick up objects from the ground C. Standing As A1, A2 and B3 * Change from sitting to standing with eyes open, then eyes closed. * Throw a small ball from hand to hand (above eye level). * Throw a ball from hand to hand under the knee. * Change from sitting to standing and turn round in between. * Weight shifting on alternate legs

OTHER

Frenkel Exercises

Warm-up, such as ankle pumping and circles, will be performed before starting the session for 5-10 minutes. Cool-down exercises like deep breathing will be performed for 5-10 minutes after the intervention. A. Lying (Supine) Exercises: Typically performed with the head raised, limbs fully supported: * Hip and knee flexion/extension: slide heel to therapist's hand or along a marked path. * Hip abduction/adduction: leg moves sideways along the plinth surface. Targeted placement practice: placing the heel on the therapist's hand or on a mark. B. Sitting Exercises Patient sits (may use support) and: * Heel-to-mark sliding: extend and lift heel or toe to visual guide Alternate heel/toe lifts: enhancing proprioceptive control * Stride sitting: stand, then sit, shifting trunk forward, possibly using wall bars for support. * Upper limb tasks: reaching loops, placing objects, hand-mouth coordination. 16 C. Standing Exercises Focus on balance and coordination: • Stride standing: weight transfer

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Zain ul abbas, MS · Children's Hospital Lahore

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-07-01

Primary Completion

2026-02-01

Completion

2026-06-01

Countries

• Pakistan

Study Locations