Effectiveness of motor relearning program in sit-to-stand transfer and activities of daily living among chronic stroke patients – a prospective, multicenter, randomized controlled trial

Abstract

Aim: Stroke is a clinically defined syndrome characterized by an acute, focal neurological deficit due to vascular injury. Strokes can result in various disabilities, including sensory and motor abnormalities, leading to difficulties with motor control, balance and posture. Physical therapists use various neurorehabilitation approaches to enhance the functional abilities and independence of stroke patients. The motor relearning program (MRP) is a task-oriented, self-monitored, structured program based on motor control theories and neuroplasticity used in the rehabilitation of stroke patients. Therefore, this study aimed to evaluate the effectiveness of MRP in improving sit-to-stand transfer and activities of daily living in individuals with chronic stroke. Materials & methods: A prospective, single-blinded, multi-centered randomized controlled trial was conducted in Saudi Arabia involving 32 chronic stroke patients randomly assigned to experimental (n = 16) and control (n = 16) groups. The experimental group received 45 minutes of MRP combined with conventional physical therapy, while the control group received conventional physical therapy alone. Interventions were delivered thrice weekly over 6 weeks (18 sessions). Outcome measures included the Barthel Index (BI) and the sit-to-stand component of the motor assessment scale (MAS), assessed pre- and post-intervention. Results: The experimental group demonstrated statistically significant improvements in both MAS and BI scores (p < 0.001), with large effect sizes (r = -0.865; for MAS, Cohen’s d = 1.46 for BI). ANCOVA analyses revealed that baseline MAS scores (MAS_pre) significantly influenced post-intervention outcomes (F[1, 29] = 65.33, p < 0.001), and the group effect remained significant after adjusting for MAS_pre (F[1, 29] = 41.89, p < 0.001). The model explained 72.6% of the variance in MAS_post scores (adjusted R 2 = 0.707), confirming the predictive strength of MRP. Similarly, BI_post scores were significantly predicted by BI_pre and group assignment (F[1, 29] = 21.15, p < 0.001), with the model accounting for 85.8% of the variance (Adjusted R 2 = 0.849). Conclusion: The motor relearning program significantly improves sit-to-stand transfer and activities of daily living performance in chronic stroke patients. Despite the small sample size and baseline MAS imbalance, these improvements remained robust after statistical adjustment, underscoring MRP’s clinical utility in neurorehabilitation. Clinical trial registration was done prospectively at https://clinicaltrials.gov/ with the registration no: NCT06690073

Affiliated Institutions

• Ministry of Health SA
• Princess Nourah bint Abdulrahman University SA
• Majmaah University SA
• Jazan University SA

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