StrokeNCT07724860
Cawthorne-Cooksey Exercises and Frenkel Exercises on Balance and Coordination in Stroke
A study testing Cawthorne-Cooksey Exercises and Frenkel Exercises in people with Stroke and Stroke (CVA) or TIA, run by Riphah International University at 1 site in Pakistan.
Trial summary
Stroke, often caused by cerebral circulation disruption can lead to transient or permanent brain function deficit it is a leading cause of disability and death globally, with a particularly high burden in low- and middle-income countries like Pakistan. Read more about this study
- Who is it for?
- Ages 40 to 75 years
- Conditions the study is for
- Stroke, Stroke (CVA) or TIA, Balance
- What is being tested?
- Cawthorne-Cooksey Exercises and Frenkel Exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 22 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Jul 2025to 1 Jun 2026
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Adults aged 40-75 years
- First-time ischemic or hemorrhagic stroke, diagnosed within the past 3-6 months (subacute phase)
- Berg Balance Scale (BBS) score between 21-40 (indicating moderate balance impairment)
- Ability to follow instructions (Mini-Mental State Exam score ≥ 24)
- No previous participation in a rehabilitation program
Who cannot join
- History of multiple strokes or recurrent strokes
- Individuals with a history of neurological deficits other than stroke, such as Parkinson's disease or multiple sclerosis
- Severe musculoskeletal disorders, visual or auditory impairments
- Any contraindications to start rehabilitation (i.e. severe uncontrolled hypertension, uncontrolled diabetes or unstable angina)
- Use of assistive devices
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Comparing the Effect of Cawthorne-Cooksey Exercises and Frenkel Exercises on Balance and Coordination in Patients With Stroke
Stroke, often caused by cerebral circulation disruption can lead to transient or permanent brain function deficit it is a leading cause of disability and death globally, with a particularly high burden in low- and middle-income countries like Pakistan.
Balance and coordination impairments are common post-stroke, severely impacting patients' mobility and quality of life. While Cawthorne-Cooksey and Frenkel exercises are low-cost rehabilitation techniques known to aid balance and coordination, there is limited evidence comparing their effectiveness in stroke patients. This study aims to evaluate and compare the effects of Cawthorne-Cooksey and Frenkel exercises on improving balance and coordination in post-stroke patients.
Specific goals include determining which protocol leads to faster and more sustained improvements and providing evidence-based recommendations for stroke rehabilitation.
Read the detailed description
Stroke, often caused by cerebral circulation disruption can lead to transient or permanent brain function deficit it is a leading cause of disability and death globally, with a particularly high burden in low- and middle-income countries like Pakistan.
Balance and coordination impairments are common post-stroke, severely impacting patients' mobility and quality of life. While Cawthorne-Cooksey and Frenkel exercises are low-cost rehabilitation techniques known to aid balance and coordination, there is limited evidence comparing their effectiveness in stroke patients. This study aims to evaluate and compare the effects of Cawthorne-Cooksey and Frenkel exercises on improving balance and coordination in post-stroke patients.
Specific goals include determining which protocol leads to faster and more sustained improvements and providing evidence-based recommendations for stroke rehabilitation. A randomized controlled trial (RCT) will be conducted with 22 stroke patients aged 40-75, 3-6 months post-stroke. Participants will be randomly divided into three groups: Cawthorne-Cooksey exercises (n=11), Frenkel exercises (n=11). Interventions will last 6 weeks, with sessions held four times weekly. outcome measures include the Berg Balance Scale and Lower Extremity Motor Coordination Test (LEMOCOT). Assessments will occur at baseline and post-intervention, and follow-up. Statistical analysis will use the Paired t-test and the independent t-test to evaluate changes across time and groups. This study addresse
- Conditions
- Stroke, Stroke (CVA) or TIA, Balance, Coordination Impairment
- Being tested
- Cawthorne-Cooksey Exercises, Frenkel Exercises
- Keywords
- Balance, Stroke, Frenkel Exercises, Coordination
- Medical subject headings
- Stroke, Ataxia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Cawthorne-Cooksey ExercisesOther
Warm up like ankle pumping and circles will be performed before starting the session for 5- 10 minutes. Cool down exercises like deep breathing will be performed for 5-10 minutes after intervention. A. In Supine Lying
- Eye movements: at first slow, then quick.
- Up and down.
- From side to side.
- Focus on finger moving from 3ft to 1ft away from face. 15
- Head movements: at first slow, then quick. Later with eyes closed.
- Bend backwards and forwards.
- Turn from side to side. B. Sitting
- 1 and 2 - as above
- Shoulder shrugging and circling
- Bend forward and pick up objects from the ground C. Standing As A1, A2 and B3
- Change from sitting to standing with eyes open, then eyes closed.
- Throw a small ball from hand to hand (above eye level).
- Throw a ball from hand to hand under the knee.
- Change from sitting to standing and turn round in between.
- Weight shifting on alternate legs
Frenkel ExercisesOther
Warm-up, such as ankle pumping and circles, will be performed before starting the session for 5-10 minutes. Cool-down exercises like deep breathing will be performed for 5-10 minutes after the intervention.
- Lying (Supine) Exercises:
Typically performed with the head raised, limbs fully supported:
- Hip and knee flexion/extension: slide heel to therapist's hand or along a marked path.
- Hip abduction/adduction: leg moves sideways along the plinth surface. Targeted placement practice: placing the heel on the therapist's hand or on a mark. B. Sitting Exercises
Patient sits (may use support) and:
- Heel-to-mark sliding: extend and lift heel or toe to visual guide Alternate heel/toe lifts: enhancing proprioceptive control
- Stride sitting: stand, then sit, shifting trunk forward, possibly using wall bars for support.
- Upper limb tasks: reaching loops, placing objects, hand-mouth coordination. 16 C. Standing Exercises
Focus on balance and coordination:
- Stride standing: weight transfer
| Study group | Role | What they receive |
|---|---|---|
| Cawthorne-Cooksey Exercise group | Experimental | Not described Receives: Other: Cawthorne-Cooksey Exercises |
| Frenkel Exercises | Experimental | Not described Receives: Other: Frenkel Exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Berg balance Scale
The Berg Balance Scale (BBS) is designed to evaluate static and dynamic balance through 14 functional tasks, each scored from 0 to 4 points, with a total possible score of 56. A higher score indicates better balance performance, while a lower score reflects greater fall risk and impaired balance
Measured: 6 weeks
Lower Extremity Motor Coordination Test
The Lower Extremity Motor Coordination Test (LEMOCOT) is a performance-based measure used to assess motor coordination deficits after stroke. The scoring system for LEMOCOT is based on the ability to move the big toe as fast and accurately as possible between targets marked on an electronic mat equipped with force sensors. The scoring involves calculating the contact surface area, endpoint location, center of pressure (COP), and distance between them. The absolute and variable errors of the endpoint are also calculated to assess the performance of the lower extremities.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2026
- Study start1 Jul 2025
- Primary completion1 Feb 2026
- Study completion1 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for StrokeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 22 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Zain ul abbas, MS, Principal investigator, Children's Hospital Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07724860
- Sponsor's protocol ID
- REC/RCR & AHS/25/0224
- Status last verified
- Jul 2026
- First submitted
- 21 Jul 2026
- Last updated
- 24 Jul 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Sherin A, Ul-Haq Z, Fazid S, Shah BH, Khattak MI, Nabi F. Prevalence of stroke in Pakistan: Findings from Khyber Pakhtunkhwa integrated population health survey (KP-IPHS) 2016-17. Pak J Med Sci. 2020 Nov-Dec;36(7):1435-1440. doi: 10.12669/pjms.36.7.2824.
PubMed 33235553Arif A, Arshad K, Tariq S, Sundas S, Tariq N, Kabir A, et al. COMPARATIVE EFFECTS OF VIRTUAL REALITY AND FRENKEL'S EXERCISES ON BALANCE, GAIT AND QUALITY OF LIFE IN PATIENTS WITH STROKE. Insights-Journal of Health and Rehabilitation. 2024;2(2 (Health & Rehab)):459-67.
Saini V, Guada L, Yavagal DR. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology. 2021 Nov 16;97(20 Suppl 2):S6-S16. doi: 10.1212/WNL.0000000000012781.
PubMed 34785599Shoeb M, Mishra A, Yadav KK, Kumar S, Yadav S. Effect of BAPS Board Versus Frenkel Exercise on Balance in Stroke Patient's-A Pilot Study.