Motor Relearning Program Combined With Neck Stabilization Exercises in Subacute Stroke

Stroke is a neurological event that leads to significant motor and functional impairments due to disruption of cerebral blood flow. The subacute phase, typically ranging from day of attack up to three months post-stroke, is a critical window for neuroplasticity and functional recovery. The proposed study will find out the effects of motor relearning program combined with neck stabilization exercises for health-related quality of life, sensorimotor function and upper extremity functionality.

Study Overview

• Status: Enrolling by invitation
• Conditions: Stroke (Subacute)
• Intervention / Treatment: Other: Motor relearning program combined with neck stabilization exercises; Other: Motor relearning program combined with routine physical therapy

Detailed Description

This is a randomized clinical trial. Target population is patients suffering from subacute stroke with an MMSE score of 24 and above. Data will be collected from The University of Lahore teaching Hospital and Shadman Medical Center. This study will include 96 participants with 10% dropout ratio, according to the selection criteria. The participants will be randomly divided into two groups through a computer-generated random number table.

Group A will recruit 48 patients to fulfil the inclusion criteria. These patients will undergo a 60 minutes session delivered for four weeks with 5 sessions every week, including warm-up, neck stabilization exercises, cranio-cervical flexion, cervical isometrics, 3 sets x 10 repetitions each 10 seconds hold, eye head coordination drills, 3 sets 60 seconds, focusing on target (right, left, up, down) neck control while reaching, 10 successful attempts, all performed in assisted sitting position. Combined with motor relearning program activities assisted supported sitting & standing grasping and releasing cylinder progressing to cloth, reaching targets forward and sideways, picking objects and transferring over shelves 2 meters apart, Coin stacking, assisted grooming and ADLs (combing hair, turning keys, drinking water) 10 successful attempts of each activity. Group B will recruit 48 patients which fulfill the inclusion criteria. These patients will be treated by routine physical therapy, evidence-based exercises including AAROM of shoulder, elbow & wrist joint, Scapular retraction, Shoulder and elbow isometrics, stretching of pectoralis minor and shoulder internal rotators, therapist assisted PNF diagonals for upper limb (Three sets of 10 repetitions each, squeeze hold for 10 seconds, stretch hold for 30 seconds and motor relearning program activities same as Group A, delivered under supervision over a timeframe of 60 minutes per session for four weeks, 5 times per week. The Statistical analysis will be performed through SPSS Software 21

• Study Type: Interventional
• Enrollment (Estimated): 96
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Shadman Medical Center
    • Lahore, Punjab Province, Pakistan, 54000
      • The University of Lahore Teaching Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients diagnosed for stroke in subacute phase by a neurologist
• Patients with Mini Mental State Examination score of 24 and above

Exclusion Criteria:

• Patients with accompanying mental Disorders (unable to cooperate)
• Fracture of upper limb in last 6 months
• Recent surgery of upper periphery effecting mobility and motor functionality
• Non consenting to intervention

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: nterventional Group A; Experimental: Interventional Group A These patients will be treated by neck stabilization exercises and motor relearning program with 3 sets of 10 repetitions each and 10 seconds along with 10 successful attempts in one session. Delivered five times a week for four weeks For this, participants will be given a comfortable assisted sitting and transition to standing position.	Other: Motor relearning program combined with neck stabilization exercises; Neck stabilization exercises and Motor relearning program based functional activities will be performed
Active Comparator: Interventional Group B; Active Comparator: Interventional Group B These patients will be treated by routine physical therapy exercises with motor relearning program with three sets of 10 repetitions each, squeeze hold for 10 seconds, stretch hold for 30 seconds repetitions in one session for 4 weeks, five times every week. For this, participants will be given a comfortable supine lying transition to assisted sitting position.	Other: Motor relearning program combined with routine physical therapy; Routine Physical therapy exercises and Motor relearning program based functional activities will be performed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensorimotor Function	Sensorimotor function will be assessed by using Urdu translated version of Fugl-Meyer Assessment (FMA) for Upper Extremity (UE)	Four weeks
Upper Limb Functionality	Functionality, assessed by using Wolf Motor Functional Test	Four weeks
Health Related Quality of Life	Health Related Quality of life will be assessed by using Stroke Impact Scale	Four weeks

Collaborators and Investigators

• Sponsor: University of Lahore

Study record dates

Study Major Dates

• Study Start (Actual): December 11, 2025
• Primary Completion (Estimated): April 20, 2026
• Study Completion (Estimated): April 20, 2026

Study Registration Dates

• First Submitted: December 30, 2025
• First Submitted That Met QC Criteria: December 30, 2025
• First Posted (Estimated): January 12, 2026

Study Record Updates

• Last Update Posted (Estimated): January 12, 2026
• Last Update Submitted That Met QC Criteria: December 30, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Motor relearning program, neck stabilization exercises, stroke (subacute)
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: UOL/IREB

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No