Stroke is a leading cause of long-term disability, with balance and gait deficits affecting \>80% of survivors and increasing fall risk. Emerging evidence links ankle proprioceptive impairment-particularly inversion/eversion acuity-to these deficits, often bilateral and central in origin. Cross-sectional studies show strong associations, but causality, temporal progression, and intervention efficacy (especially in severe/non-ambulatory cases) remain unproven. This trial tests a targeted proprioceptive protocol against standard care.
Objectives: Primary: To evaluate the causal effect of 12-week targeted ankle proprioceptive training on weight-bearing ankle proprioception (AMEDA) in chronic stroke survivors. Secondary: To assess effects on balance (Berg Balance Scale), gait speed (10m walk test), mobility (Timed Up and Go, Functional Ambulation Category), lower extremity motor function (Fugl-Meyer), and sustainability at 6-month follow-up. To describe longitudinal proprioceptive changes in a subsample from acute to chronic stages.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
140
Both groups: 12 weeks, 3 sessions/week × 60 min, supervised. Intervention Group (n=70): Progressive targeted ankle proprioceptive training
IQRA National University
Swāt, Peshawar, Pakistan
Primary outcome
Active Movement Extent Discrimination Apparatus for measuring propioceptive acuity
Time frame: post-12 weeks, 6-month follow-up. Longitudinal subsample assessed from acute (<1 month) to chronic.
Secondary outcome
Berg Balance Scale for assessment of static balance and fall risk.
Time frame: post-12 weeks, 6-month follow-up. Longitudinal subsample assessed from acute (<1 month) to chronic.
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