Effect on Gait Performance in MCA Territory Stroke Patients Using Designed Structured Exercise Protocol Versus Conventional Exercises

Abstract

Background: Stroke is a major cause of disability worldwide, with gait impairment being one of its most disabling sequelae. Physiotherapy plays a crucial role in promoting neuroplasticity and restoring functional mobility. A structured exercise protocol (SEP-G) may provide greater improvements in gait performance than conventional rehabilitation exercises. Methods: A prospective interventional study was conducted over two years in a tertiary care hospital. Eighty patients with unilateral MCA territory stroke were randomly allocated into two groups: Structured Exercise Protocol (SEP-G, n=40) and Conventional Therapy (CT, n=40). Both groups underwent supervised physiotherapy sessions three times per week for four weeks. Gait performance was assessed using stride length, step length, cadence, walking speed, and the 2-Minute Walk Test (2MWT). Within-group comparisons were performed using paired t-tests, while between-group comparisons were analyzed using unpaired t-tests. Results: Both groups demonstrated significant improvements following intervention. In the SEP-G group, significant improvements were observed in stride length (p=0.036), step length (p=0.001), cadence (p=0.001), walking speed (p=0.001), and 2MWT distance (p=0.001). The conventional therapy group also showed significant improvements in stride length (p=0.001), step length (p=0.007), cadence (p=0.001), and 2MWT distance (p=0.003), whereas improvement in walking speed was not statistically significant (p=0.371). Between-group comparison revealed significantly greater improvements in cadence (p=0.001) and walking speed (p=0.001) in the SEP-G group, while differences in stride length, step length, and 2MWT distance were not statistically significant. Conclusion: Both structured exercise protocol and conventional exercises effectively improved gait performance in patients with MCA territory stroke. However, the structured exercise protocol produced superior improvements in cadence and walking speed, indicating that it may be a more effective rehabilitation strategy for enhancing gait performance after stroke