Comparative Effects of Task-Oriented Training and Hand-Arm Bimanual Intensive in Post-Stroke Patients

This randomized clinical trial will be conducted at District Headquarter Hospital Nankana Sahib on 30 stroke patients, randomly assigned to two groups through seal opaque method. Group A will receive task-oriented training and Group B will undergo hand-arm bimanual therapy over an 8-week period. Outcome measures will include Action Research Arm Test for gross movement of upper limb and fine motor functions will be assessed using the Nine Hole Peg Test, while the Barthel Index will be used for daily activity performance. Pre and post-intervention assessments will be used to analyze and compare the effects of interventions. Data will be analyzed using the SPSS version 25. Statistical significance will be set at p=0.05. The normality of data will be checked by Shapiro wilk test (p-value 0.05). Difference between groups will be analyzed through Independent sample t-test/Mann-Whitney Test within group comparison will be analyzed through Paired sample t-test/Wilcoxen Signed-Rank test depending upon the normality of data.

Inclusion criteria

• • Age 45-70

• Gender (both male and female)
• Pre diagnosed First-time stroke patients (ischemic or hemorrhagic)
• Time since stroke: ≥3 months
• Mild to moderate upper limb impairment (ABILHAND Questionnaire: Less than 50% of items rated as "impossible.")
• Moderate functional independence in basic activities (Barthel Index score ≥ 60)
• Ability to follow commands (MMSE > 24 or equivalent cognitive screening)

Exclusion criteria

• • Severe spasticity (Modified Ashworth Scale score ≥ 3) or contractures

• Other neurological conditions (Alzheimer's disease, Parkinson and dementia)
• Unstable medical conditions (diabetes and hypertension) that may interfere with participation
• Participation in any other structured upper limb rehabilitation or experimental therapy within the past 3 months