Clinical Research Directory

Inclusion Criteria: * Sixty eight first-ever unilateral ischemic stroke patients as diagnosed by CT ''computed topography'' or MRI ''magnetic resonance imaging. * Patients will be both sexes. * Their age ranges from 45 to 60 years * The patients will be divided into 2 groups based on their level of ankle plantar flexor spasticity according to the Modified Ashworth Scale (MAS): * Low spasticity (grade 1 and 1+). * High spasticity (grade 2 and 3). * Duration of illness will be over 6 months post-stroke. * Body mass index of patients will be ≤ 30 kg / m2 * Patients can stand independently. * Normal cognitive abilities according to MOKA scale will be ≥ 24 Exclusion Criteria: * Bilateral hemiplegia. * Patients having any other neurological disorders affecting their lower limb extremity as MS, Parkinson disease, peripheral neuropathy. * Patients with visual auditory impairment affecting their ability to complete task. 4.Patients with previous fracture of the lower limbs or any other musculoskeletal disorders such as severe arthritis, fixed ankle contracture, ankle surgery, leg length discrepancy or being treated with botulinum toxin injections within the past 3 months of study participation.