Effect of Wobble Board Exercises Versus Swiss Ball Exercises on Balance and Functional Stability of Stroke Patients

A stroke is characterized as a condition in which the brain's main arteries get clogged, reducing oxygen flow and potentially leading to death or severe disability. There are various types of strokes, such as transient ischemic attack (TIA), hemorrhagic stroke, and ischemic stroke. Hemorrhagic stroke is the most prevalent kind among them Strokes frequently alter postural balance. Balance is a complicated process that involves both static and dynamic elements. It significantly influences gait performance and community ambulation after strokes. Balance impairment is a common cause of falls in stroke survivors.

Post-stroke recovery is related to loss of control of one's body posture, uneven weight distribution, and lack of anticipatory and reactive balance, which hinder movement in the community and severely affect one's quality of life. The loss of balance is one of the major problems that stroke patients have to deal with and is considered the most serious part of the illness. Medically, it is characterized as the result of multiple factors such as: i) damage to brain areas responsible for processing vestibular input, ii) blockage for proprioceptive feedback, iii) poor coordination among the different brain regions involved in motor planning and execution and visual feedback. These factors, in turn, and together, block the person's body from moving stably during static and dynamic activities. More than 70% of stroke patients develop significant balance problems within the first year of the stroke and such problems, besides other factors, are the reason for the high occurrence of falls among them. Reports indicate that the fall rate in the stroke population is more than double that in the non-disabled elderly.

Study Overview

• Status: Not yet recruiting
• Conditions: Stroke
• Intervention / Treatment: Other: Wobble Board Exercises; Other: Swiss Ball Exercises

Detailed Description

A stroke is categorized by a local neurological deficiency that progresses suddenly and persists longer than twenty-four hours, which led to death before time . Stroke, the disruption of blood supply to the brain, remains the top cause of debility that lasts for long time, creating considerable socioeconomic and healthcare issues all over the world. The ads need to show that this condition can sometimes lead to serious cases where the person is not able to control or feel anything, is not able to balance, or walk, and is not functioning independently. Over the last few years, research has shown that each year there are more than 12 million new strokes all over the world and many people who have survived stroke undergo through a long process of rehabilitation whereby they are only taught how to get back to functioning more or less and at the same time to be less prone to falling.

• Study Type: Interventional
• Enrollment (Estimated): 38
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Imran Amjad, PhD; Phone Number: 03324390125; Email: Imran.amjad@riphah.edu.pk

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Participants were required to have a history of stroke (>6-months)
• Age; 40-60 years old both male and female.
• Patients who have Ischemic or Hemorrhagic stroke
• Participants must tolerate at least 30 minutes of seated or standing activity to participate in the program progressively.
• Participants must have intact or corrected eyesight in order to use the equipment and visual balancing cues properly.
• The participant should be able to stand with little assistance and sit on their own.

Exclusion Criteria

• Subjects with impaired visual or vestibular impairment and systemic illness
• Subjects unable to provide a proper medical history
• Subjects with neuropathies due to non-diabetic cause
• Subjects with any other neurological condition that can impair balance
• Subjects with any other musculoskeletal conditions that cause pain and instability
• Subjects with severe diabetes with foot ulcers or foot deformities
• Subjects with any kind of lower limb amputation.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Wobble Board Exercises; Exercises: Static Standing: Participants stand on the wobble board with assistance as needed to develop balance without causing undue strain on spastic muscles.; Gentle Weight Shifts: Controlled side-to-side and front-to-back shifts (10-15 repetitions) for proprioception and core activation, adjusted to individual spasticity levels.; Static Balance Drills: Standing on the wobble board with increasing independence, focusing on postural alignment and balance.; Heel-to-Toe Walking: Slow, controlled steps (10 repetitions) on a stable surface to promote coordination and foot placement control.; Controlled Weight Shifts:	Other: Wobble Board Exercises; Duration: 10 minutes per session Frequency: 3 sessions per week Objective: Establish foundational balance in standing for mild-to-moderate spasticity levels. Exercises: Static Standing: Participants stand on the wobble board with assistance as needed to develop balance without causing undue strain on spastic muscles.; Gentle Weight Shifts: Controlled side-to-side and front-to-back shifts (10-15 repetitions) for proprioception and core activation, adjusted to individual spasticity levels. Duration: 25 minutes per session Frequency: 3 sessions per week Objective: Gradual increase in static balance exercises to enhance postural control without exceeding tolerance levels. Exercises: Static Balance Drills: Standing on the wobble board with increasing independence, focusing on postural alignment and balance.; Heel-to-Toe Walking: Slow, controlled steps (10 repetitions) on a stable surface to promote coordination and foot placement control.; Controlled Weight Shifts:
Experimental: Swiss Ball Exercises; Seated Balance: Sitting on Swiss ball to activate the core without overstressing spastic or weak muscles.; Gentle Bouncing: Slow, controlled bounces (10-15 repetitions) to improve dynamic seated stability within a safe range for those with mild to moderate spasticity Single-Leg Balance (Assisted): Alternating seated balance on one leg (10-15 repetitions each leg), ensuring safety for spasticity concerns.; Bridges: Controlled bridging to improve core and glute strength without stressing lower limb spasticity.; Side Bends: Slow side bends (10-15 repetitions per side) to activate lateral stabilizers without excess strain.	Other: Swiss Ball Exercises; Duration: 10 minutes per session Frequency: 3 sessions per week Objective: Build initial seated balance and core activation on the Swiss ball. Exercises: Seated Balance: Sitting on Swiss ball to activate the core without overstressing spastic or weak muscles.; Gentle Bouncing: Slow, controlled bounces (10-15 repetitions) to improve dynamic seated stability within a safe range for those with mild to moderate spasticity Duration: 25 minutes per session Frequency: 3 sessions per week Objective: Increase core stability and seated balance while avoiding excessive muscle fatigue. Exercises: Seated Balance Drills: Static seated balance drills to reinforce postural control.; Pelvic Tilts: Gentle, slow tilts (10 repetitions per side) to engage core stabilizers without excessive hip muscle strain.; Simple Reaches: Reaching exercises (10 repetitions per direction) that challenge seated stability in a controlled range of motion. Duration: 30 minutes per session

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
(FSST) Four-Square Step Test	The Four-Square Step Test (FSST) is a dynamic evaluation tool for balance and coordination in which participants step forward, sideways, and backward over four canes set in a cross pattern. Score is determined by the time that it takes to finish; two trials are made, and the best time is noted. Research has confirmed its reproducibility and validity, such as musculoskeletal problems, neurological illnesses, and elderly adults. With a cut-off period of 15 seconds, it accurately detects fall risk, with older persons having a larger chance of falling	2 to 4 mins
Berg Balance Scale (BBS)	An instrument that is frequently used to evaluate an adult's balance and fall risk is the Berg Balance Scale (BBS). It has 14 tasks with a maximum score of 56, and each activity is rated on a scale of 0 to 4. Improved balance is indicated by higher scores. Low fall risk is indicated by scores 41-56, medium fall risk by scores 21-40, and high fall risk by scores 0-20. Particularly in stroke rehabilitation, it predicts functional results and correlates well with other balance measures	2 to 4 mins

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Sobia Kanwal, tDPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Estimated): February 28, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): August 30, 2026

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 20, 2026

Study Record Updates

• Last Update Posted (Actual): March 20, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: S24C14G37001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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