Comparison of Otago Exercises versus Resistance Training on Functional Performance in Stroke Patients: A Randomized Controlled Trial

Abstract

Background: Stroke often results in long-term impairments in balance, muscle strength, and mobility, which can significantly impact patients’ independence and quality of life. The Otago exercise program and resistance training are commonly used interventions targeting lower limb strength and balance. Objective: To compare the effects of Otago exercises and resistance training on functional performance among chronic stroke patients. Methodology: This single-blinded controlled trial was conducted over six months at the Yusra Institute of Rehabilitation Sciences. The study included stroke survivors aged 40 to 60 years, both genders, with onset exceeding six months before enrollment. Subjects presented with cognitive deficits, comorbidities, or contraindications to exercise were excluded from the study. Randomization employed a sealed envelope technique to allocate participants equally into two groups: the control group received resistance training, and the treatment group performed Otago exercises. The intervention spanned four weeks, with thrice-weekly sessions held on alternate days in a supervised clinical environment. Muscle strength quantification employed a crane scale dynamometer targeting major lower limb muscle groups. Balance was evaluated using the four-stage balance test, a validated clinical measure of static postural control. Gait speed was assessed using the timed up and go test, reflecting functional mobility and fall risk. Quality of life was measured with the stroke-specific quality of life scale, encompassing physical, cognitive, and psychosocial domains. Within-group comparisons utilized paired t-tests to evaluate pre- to post-intervention changes, while independent t-tests assessed between-group differences. Results: The mean age was 55.30±5.06 years in the control group and 55.27±6.09 years in the treatment group. No significant between-group differences were found in balance, quadriceps, hamstring, iliopsoas, tensor fasciae latae strength, or gait speed (p>0.05). However, the treatment group showed significantly greater improvement in gluteus maximus strength and quality of life. Conclusion: Otago exercises were not superior to resistance training in improving balance, general lower limb strength, or gait speed, but showed greater benefit in gluteus maximus strength and quality of life.