Comparative Effects of Coordinative Locomotor Training Using Sprinter Versus Skater Coordination Synergies on Balance and Coordination in Patients With Chronic Stroke: A Randomized Clinical Trial

Background: Chronic stroke survivors often experience persistent deficits in balance and coordination due to damage to motor control pathways in the brain. These deficits limit independence, increase fall risk, and reduce quality of life. Coordinative Locomotor Training (CLT) is a rehabilitation approach that integrates Proprioceptive Neuromuscular Facilitation (PNF) patterns with whole-body movement sequences. The sprinter coordination synergy mimics a runner's movement: on one side, the upper extremity moves into flexion, adduction, and external rotation while the ipsilateral lower extremity moves into extension, adduction, and internal rotation. The skater coordination synergy mimics a speed skater: on one side, the upper extremity moves into flexion, abduction, and external rotation while the lower extremity moves into extension, adduction, and external rotation. Both patterns activate the whole body with one leg functioning in a closed chain position.

Objectives: To compare the effects of sprinter coordination synergy versus skater coordination synergy on: (1) static and dynamic balance measured by Berg Balance Scale (BBS) and Functional Reach Test (FRT); (2) coordination and functional mobility measured by Timed Up and Go (TUG) test. Secondary objectives include determining which technique shows significantly greater improvement and providing evidence-based recommendations for physiotherapy practice in Pakistan.

Study Design: Randomized, parallel-group, double-blind clinical trial.

Setting: Outpatient rehabilitation department, Aziz Fatima Hospital and In Motion Clinic, Faisalabad, Punjab, Pakistan.

Sample Size: Twenty-two participants (11 per group). Sample size calculated based on effect sizes from previous similar studies (Kim, Lee and Jung, 2015), with 20% allowance for attrition (n=4).