Evaluating the Impact of Active vs Passive Physiotherapy Techniques on Post-Stroke Motor Recovery in Adults

Abstract

Background: Stroke is a major cause of long-term adult disability and commonly results in weakness, impaired coordination, poor balance, and reduced functional mobility. Physiotherapy is central to post-stroke rehabilitation, but the comparative effectiveness of active versus passive approaches remains insufficiently defined in many local clinical settings. Objective: To compare the effects of active and passive physiotherapy techniques on motor recovery among adult post-stroke patients. Methods: This randomized controlled trial was conducted at a tertiary care hospital in Northwestern Punjab, Pakistan. Sixty adult post-stroke patients were randomly allocated into active physiotherapy and passive physiotherapy groups, with 30 participants in each group. The active group received voluntary movement exercises, task-based training, balance activities, and mobility practice, while the passive group received passive range-of-motion exercises, stretching, positioning, and therapist-assisted limb movement. Both groups received treatment five days per week for eight weeks. Muscle strength, coordination, and functional mobility were assessed before and after treatment using Manual Muscle Testing, clinical coordination assessment, and the Timed Up and Go Test. Results: Active physiotherapy produced greater improvement than passive physiotherapy in muscle strength (1.5 ± 0.5 vs 0.8 ± 0.4), coordination (3.3 ± 1.0 vs 1.5 ± 0.8), and Timed Up and Go performance (10.9 ± 3.1 vs 5.2 ± 2.6 seconds), with statistically significant between-group differences. Conclusion: Active physiotherapy demonstrated superior short-term improvement in post-stroke motor recovery compared with passive physiotherapy.