This randomized controlled trial aims to compare the effectiveness of Vestibular-Oriented Balance Training and Motor Dual Task Training on balance, postural control, and fall risk among chronic stroke survivors. Forty-six participants diagnosed with chronic stroke will be randomly allocated into two intervention groups. Both groups will receive conventional physiotherapy along with their assigned intervention for six weeks. Outcome measures will include the Biodex Balance System (Overall Stability Index, Anterior-Posterior Stability Index, Medial-Lateral Stability Index and Fall Risk Index), Modified clinical test of sensory interaction on balance( m-CTISB). The findings will provide evidence regarding the most effective rehabilitation strategy for improving, Overall stability, and functional balance and reducing fall risk in chronic stroke survivors.
Diagnosis of ischemic stroke.
Stroke duration ≥6 months.
Rhomberg scale
MMSE ≥ 24
Severe visual impairements which effect balance.
Participants with acute or sub acute stroke <6 moths.
Uncontrolled hypertension
Uncontrolled diabetes
Parallel
Experimental
Other interventionParticipants will receive vestibular-oriented balance exercises together with conventional physiotherapy for five weeks
Control
Other interventionParticipants will receive motor dual-task balance training together with conventional physiotherapy for five weeks.
Biodex Over all stability Index
Overall Stability Index (OSI) on the Biodex Balance System is a comprehensive score measuring how well a person controls their balance and keeps a moving platform level. Higher numbers mean more platform tilt and poorer balance control, while lower numbers show better stability and stronger neuromuscular coordination.
Biodex Fall Risk index
It measures a person's stability and risk of falling by tracking how much they sway on a moveable balance platform. Higher scores indicate poor stability and a higher likelihood of falls
Modified clinical test of sensory interaction on balance
a clinical tool used to evaluate static postural control and identify which sensory systems (vision, vestibular, or somatosensory/proprioceptive) a patient relies on or struggles with to maintain balance.
Biodex APSI
Anterior/Posterior Stability Index (APSI) on the Biodex Balance System measures front-to-back postural sway and balance ability. Higher scores indicate greater platform displacement and poorer stability, while lower scores reflect better front-to-back neuromuscular control and stability.
Biodex Medial/Lateral Stability Index
A lower score indicates better stability, meaning the person stayed closer to the center level. A higher score represents greater side-to-side sway, indicating poor postural performance or a higher risk of falling.
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