Study Protocol for a Randomized Controlled Trial Comparing Swiss Ball Balance Training and Conventional Balance Training to Improve Trunk Control and Mobility in Individuals with Sub acute Stroke

Stroke is a leading cause of mortality and long-term disability worldwide, with low- and middleincome countries carrying the greatest burden. Impaired trunk control and balance are common after stroke, severely limiting mobility and independence and increasing the risk of falls. Conventional balance training is widely used to improve stability, but it primarily targets static postural control and may not sufficiently activate trunk muscles during dynamic tasks. Swiss ball balance training, which uses an unstable surface to engage core musculature and enhance sensorimotor integration, has shown promising results in improving trunk control and functional mobility. However, research comparing Swiss ball balance training with conventional balance training is limited, particularly in Sub-Saharan Africa. This study aims to compare the effects of Swiss ball training and conventional balance training on trunk control, balance, and mobility in individuals with subacute stroke.

A randomized, assessor-blinded, two-period, two-sequence crossover trial will be conducted. Participants will be randomly assigned to Swiss Ball Balance Training or Conventional Balance Training, each administered for 45 minutes per session, three days per week, over six weeks, with a one-week washout period between phases. Standardized clinical outcome measures will assess trunk control, postural stability, and functional mobility at baseline and after each intervention phase. Data will be analyzed using paired t-tests and Wilcoxon rank-sum tests in Stata v17 (p < 0.05).

It is expected that Swiss ball exercises will yield greater improvements in trunk control, balance performance, and functional mobility than conventional methods. The results are expected to help design context-specific rehabilitation programs.