Effectiveness of a Multimodal Neuro-Physiotherapy Program Combining Task-Specific Training, Mirror Therapy, and Proprioceptive Neuromuscular Facilitation on Upper Limb Function, Spasticity, Balance, and Gait in Subacute Stroke Patients: A Quasi-Experimental Study

Objective: To evaluate the effectiveness of a 6-week multimodal neuro-physiotherapy programme combining task-specific training, mirror therapy, and proprioceptive neuromuscular facilitation (PNF) on upper limb motor function, spasticity, balance, and gait speed in patients with subacute stroke. Methods: A quasi-experimental, one-group pretest-posttest study was conducted on 40 subacute stroke patients (2 weeks to 3 months post-stroke) recruited by purposive sampling from neuro-rehabilitation centres in Surat, Gujarat. Participants received 60-75-minute sessions, 5 days/week for 6 weeks, combining mirror therapy, PNF, and task-specific training with balance and gait training. Outcomes-Fugl-Meyer Assessment Upper Extremity (FMA-UE), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), and 10-Meter Walk Test (10MWT)-were recorded at baseline and after 6 weeks by a blinded assessor and compared using paired t-tests (α = 0.05). Results: Mean age was 57.6 ± 8.9 years (65% male; 70% ischaemic stroke). All four outcomes improved significantly (p < 0.001): FMA-UE rose from 28.4 ± 9.7 to 45.2 ± 8.5 (mean difference 16.8, 95% CI 14.1–19.5); MAS fell from 2.4 ± 0.6 to 1.3 ± 0.5 (mean difference –1.1, 95% CI –1.33 to –0.87); BBS rose from 31.2 ± 7.8 to 46.5 ± 6.4 (mean difference 15.3, 95% CI 13.2–17.4); and 10MWT gait speed rose from 0.42 ± 0.18 to 0.68 ± 0.15 m/s (mean difference 0.26, 95% CI 0.21–0.31). Cohen's d ranged from 1.56 to 2.31 (large effects) across all outcomes. Conclusion: A structured 6-week multimodal programme combining task-specific training, mirror therapy, and PNF was associated with large, statistically significant gains in upper limb function, spasticity, balance, and gait speed in subacute stroke patients. In the absence of a control group, these gains cannot be fully separated from spontaneous neurological recovery; controlled trials are needed before the protocol can be recommended as superior to conventional therapy.