Clinical Research Directory

Inclusion Criteria: * Patients will be included if they are ≥ 55 years old of both sex, had a first-time right or left stroke within the preceding six months that damaged the cerebral cortex verified by (computed tomography or MRI report, neurological examination, and medical chart). * Patients can stand and walk independently. * Modified Ashworth Scale (MAS) of upper limb muscle ≤ 1+. * All the patients received a conventional physiotherapy program in the acute stage and post-discharge from the hospital. * None of the patients participated in any other study or placebo Exclusion Criteria: * Patients with neurological or orthopedic problems, paralysis neglect, behavioral abnormalities, dementia any shoulder dysfunction before or post-stroke (dislocation or subluxation), or those who using upper limb splints. * Recurrent strokes or hemiparesis due to other neurological causes rather than stroke eg .(Brain tumor). * Obesity (BMI ≥ 30 kg/m2).