COMPARISON OF TAI CHI AND FRENKEL’S EXERCISES TO IMPROVE BALANCE, FALL RISK AND ACTIVITIES OF DAILY LIVING IN PATIENTS WITH STROKE

Abstract

Background: Stroke is a leading cause of adult disability, often resulting in impaired balance, increased fall risk, and reduced ability to perform activities of daily living (ADLs). Recovery depends on early and effective rehabilitation strategies that enhance motor control and coordination. Tai Chi, a traditional Chinese movement practice, and Frenkel’s exercises, a proprioceptive training regimen, are both used to address these deficits in neurological populations. However, limited evidence exists comparing their effectiveness in stroke rehabilitation.

Objective: To compare the effects of Tai Chi and Frenkel’s exercises on improving balance, fall risk, and ADLs in stroke survivors.

Methods: This randomized clinical trial was conducted at the Outpatient Physiotherapy Department of Islam Central Hospital, Sialkot, from November 2023 to June 2024. A total of 36 stroke patients were recruited through non-probability convenience sampling and randomly assigned into two groups (n=18 each). Group A received modified Tai Chi training along with conventional physiotherapy, while Group B received Frenkel’s exercises with conventional therapy. Outcome measures included the Berg Balance Scale (BBS) for balance, the Barthel Index (BI) for ADLs, and the STRATIFY tool for fall risk. Assessments were conducted at baseline and after 8 weeks. Data were analyzed using SPSS version 26, applying independent sample t-tests.

Results: Post-intervention scores showed significant improvements in all outcome measures in both groups (p < 0.05). However, Group A (Tai Chi) demonstrated superior outcomes with BI improving from 58.13 ± 9.81 to 85.63 ± 7.93, BBS from 35.81 ± 4.34 to 45.38 ± 3.32, and STRATIFY scores decreasing from 2.62 ± 0.957 to 0.94 ± 0.680. In contrast, Group B (Frenkel’s) showed less pronounced gains (BI: 56.88 ± 10.94 to 69.38 ± 9.81; BBS: 35.50 ± 4.38 to 41.94 ± 2.64; STRATIFY: 2.56 ± 0.892 to 1.68 ± 0.602), with significant between-group differences (p < 0.05).

Conclusion: Both Tai Chi and Frenkel’s exercises contributed positively to stroke rehabilitation; however, Tai Chi demonstrated superior efficacy in improving balance, reducing fall risk, and enhancing ADL performance in stroke patients.