Therapeutic efficacy of Unani management in post stroke disability: A review of literature

Stroke is a leading cause of long-term disability and death globally, with a rising burden in low- and middle-income countries. Despite advancements in acute care, post-stroke rehabilitation remains complex and often incomplete. The Unani system of medicine, with its holistic principles and temperament-based diagnostics, provides an alternative approach to managing post-stroke disability particularly hemiplegia (Falij). Unani scholars such as Hippocrates, Galen, Ibn Sina, and Zakariya Razi described Falij centuries ago, attributing it to the obstruction of vital forces due to humoral imbalances, particularly the accumulation of Balgham (phlegm). Management strategies in Unani include Ilaj bil Tadbeer (regimental therapy), Ilaj bil Dawa (medication), and Ilaj bil Ghiza (dietotherapy). Therapies like Fasd (venesection), Hijama (cupping), Dalk (massage), and warming interventions are used to stimulate nerve function, reduce obstructions, and restore balance. This review explores the classical understanding and therapeutic approaches to Falij in Unani medicine and highlights their potential role in enhancing post-stroke rehabilitation. Though promising, these therapies require further scientific validation through well-designed clinical studies to support their integration into modern neurorehabilitation care.