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@article{194763,
        author = {Pavithra S and Dr Thillai Vignesh and Dr Natasha Verma and Dr Akansha Gaur},
        title = {COMPARATIVE EFFICACY OF VISUAL-COGNITIVE VERSUS TASK-ORIENTED APPROACHES FOR POSTURAL CONTROL RECOVERY IN SUB-ACUTE STROKE},
        journal = {International Journal of Innovative Research in Technology},
        year = {2026},
        volume = {12},
        number = {10},
        pages = {5426-5433},
        issn = {2349-6002},
        url = {https://ijirt.org/article?manuscript=194763},
        abstract = {Background: Postural instability is a cardinal and disabling deficit following stroke, affecting over 80% of survivors and leading to significant mobility limitations, high fall risk, and profound dependency in daily activities. The sub-acute phase, a critical period for neuroplasticity, is the primary window for rehabilitative interventions. Conventional rehabilitation often includes Task-Oriented Training (TOT), a "bottom-up" approach grounded in motor learning principles that emphasizes functional task repetition. Conversely, Visual-Cognitive (VC) training has emerged as a distinct "top-down" strategy, using modalities like virtual reality, augmented feedback, and visual-spatial tasks to retrain the brain's capacity for sensory integration and motor planning. While both are clinically utilized, their comparative efficacy for postural control recovery remains poorly elucidated.
Objective: This review aims to systematically synthesize and critically appraise emerging evidence concerning the comparative efficacy of Visual-Cognitive (VC) training versus Task-Oriented Training (TOT) on postural control recovery, functional mobility, and activities of daily living (ADLs) in patients within the sub-acute phase of stroke.
Methods: A comprehensive literature search was conducted for interventional studies, including randomized controlled trials (RCTs) and comparative studies, published between 2010 and 2025. Studies involving patients with sub-acute stroke (defined as 7 days to 6 months post-onset) that directly compared a VC intervention with a TOT intervention were prioritized. Data extracted included intervention protocols (frequency, intensity, duration, type), participant characteristics, primary and secondary outcome measures (e.g., Berg Balance Scale, Timed Up and Go Test, Fugl-Meyer Assessment, gait parameters, force plate metrics, and functional independence measures), and principal findings regarding postural control.
Results: Both VC and TOT interventions, when compared independently to conventional therapy, demonstrated significant improvements in balance and functional mobility. However, direct head-to-head comparative studies are scarce. Emerging evidence suggests potentially divergent mechanisms; VC training appears to yield specific benefits in sensory processing domains, such as enhanced visual-spatial integration, improved static balance (center of pressure sway), and expanded limits of stability. In contrast, TOT shows robust effects on the performance of trained functional tasks, such as sit-to-stand transfers and walking velocity, consistent with its foundation in motor learning and specificity of training.
Conclusion: Both VC and TOT are effective and viable strategies for enhancing postural control in sub-acute stroke rehabilitation, likely operating through complementary neural pathways. The optimal choice may be patient-specific, dependent on the primary nature of the deficit (e.g., sensory processing vs. motor execution impairment). A combined approach that integrates VC elements to prime the sensorimotor system with task-oriented practice to consolidate functional skills may be optimal. Further large-scale, head-to-head RCTs with standardized protocols and long-term follow-up are warranted to delineate the superior approach or a potential synergistic effect.},
        keywords = {Stroke, VC, TOT, Visual-cognitive, Task-oriented Approaches, Postural control},
        month = {March},
        }