COMPARING THE EFFECTIVENESS OF SUSPENSION THERAPY AND CLOSED CHAIN EXERCISES FOR IMPROVING FUNCTIONAL OUTCOMES IN STROKE SURVIVORS: A RANDOMIZED CONTROL TRIAL

Background: Stroke commonly leaves survivors with impaired balance, slow gait, and reduced independence, particularly during the subacute stage when recovery potential remains clinically important. Rehabilitation strategies that improve weight bearing, trunk control, and safe stepping are therefore central to functional recovery. Closed kinetic chain exercises are widely used for lower limb control, whereas suspension therapy may provide a safer environment for balance and gait training. Direct comparison of these approaches remains limited in stroke rehabilitation. Objective: To compare the effectiveness of suspension therapy and closed kinetic chain exercises in improving balance and gait speed among patients with subacute stroke. Methods: This parallel two-arm randomized controlled trial included 68 patients with subacute stroke who were randomly allocated to the closed kinetic chain exercise group (n = 34) or suspension therapy group (n = 34). Both groups received conventional physical therapy along with the assigned intervention for six weeks, five days per week, with each session lasting 30–45 minutes. Balance was assessed using the Berg Balance Scale, while gait speed was measured using the 10-Meter Walk Test at baseline and after intervention. Within-group changes were analyzed using the Wilcoxon signed-rank test, and between-group change scores were compared using the Mann–Whitney U test. Results: No participant withdrew from the study. Both groups were similar in age and gender distribution at baseline. In the closed kinetic chain exercise group, Berg Balance Scale score improved from 28.0 to 43.0, with a median change of 15.0 (Z = -5.10, p < .001, r = .88), while gait speed improved from 0.330 m/s to 0.500 m/s, with a median change of 0.180 m/s (Z = -5.10, p < .001, r = .88). In the suspension therapy group, Berg Balance Scale score improved from 28.50 to 41.00, with a median change of 14.00 (Z = -5.09, p < .001, r = .87), while gait speed improved from 0.325 m/s to 0.485 m/s, with a median change of 0.165 m/s (Z = -5.09, p < .001, r = .87). Between-group differences were not statistically significant for Berg Balance Scale (p = .146) or 10-Meter Walk Test (p = .490). Conclusion: Both suspension therapy and closed kinetic chain exercises significantly improved balance and gait speed in patients with subacute stroke. Neither intervention showed superiority, suggesting that both may be useful rehabilitation options depending on patient needs, therapist expertise, and available resources. Keywords: Balance, Exercise Therapy, Gait, Rehabilitation, Stroke, Walking Speed, Weight-Bearing