Synergistic Effect of Iontophoresis and Motor Imagery Training on Upper Limb Functional Reach in Subacute Stroke Patients

Introduction Stroke is a leading cause of long-term disability, with upper limb dysfunction being one of the most common impairments affecting independence in daily activities. Reduced functional reach is often associated with spasticity, muscle weakness, and impaired motor planning. Conventional physiotherapy primarily focuses on physical rehabilitation but may not sufficiently address both peripheral and central mechanisms involved in recovery. Therefore, combining peripheral interventions such as iontophoresis with central strategies like motor imagery (MI) may enhance functional outcomes. This study aimed to evaluate the synergistic effect of iontophoresis combined with MI training on upper limb functional reach in subacute stroke patients. Methods This experimental study included 34 subacute stroke patients (40-60 years) randomly allocated into Group A (conventional therapy with magnesium sulphate iontophoresis) and Group B (conventional therapy with iontophoresis plus MI). Interventions were administered for six weeks (five sessions/week). Outcome measures included the Functional Reach Test (FRT), Modified Ashworth Scale (MAS), and Fugl‑Meyer Assessment (FMA)-upper‑limb component. Pre‑ and post‑intervention data were analyzed using paired and unpaired t‑tests. Results Both groups showed significant post‑intervention improvements; however, Group B demonstrated significantly greater gains. The mean FRT improved by 11.18 cm in Group B compared to 2.31 cm in Group A (p < 0.0001). MAS and FMA scores also showed highly significant intergroup differences (p < 0.0001), indicating greater reduction in spasticity and improvement in voluntary motor control with the combined approach. Conclusion The addition of MI to iontophoresis and conventional therapy produces superior improvement in upper‑limb functional reach and motor recovery in subacute stroke patients, offering a feasible and cost‑effective neurorehabilitation strategy.