Comparative Effects of Cawthrone Cooksey Exercises and Frankle's Exercises on Improving Balance and Quality of Life in Geriatrics Population

NCT07785232 | Completed

• 1 other identifier: TUF/IRB/94/2025
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

Geriatrics are one of the most vulnerable groups in any community, as they are at risk for poor balance, falls, injuries, a decline in their independence and quality of life and early mortality. The goal of the study was to examine the effects of Frankel's exercise and Cawthrone and Cooksey exercises (CCE) on balance and quality of life in older adults, given the importance of balance in performing ADLs and its impact on quality of life. The geriatric population was the subject of a randomized clinical trial. Twenty-six individuals 50 years of age and older who were enrolled at the Madinah Teaching Hospital and the old age home took part in this clinical trial investigation. They were split into two groups using a random number generator (13 in the Caw Throne Cooksey exercise group and 13 in the Frankel's group). The balance disorder questionnaire was used for screening. One group engaged in three 60-minute Caw throne Cooksey exercise sessions every week for two month. The other group was exercise their frankel's three times a week at the same period. The participants' quality of life was assessed using the SF36, Quality of Life Questionnaire, and the Berg balance test both before and after the two-month intervention. SPSS version 23 was used for data analysis. Every research subject was provided both written and verbal informed consent.

Conditions

Balance Control in Elderly; Quality of Life

Keywords

Balance; Cawthrone Cooksey exercices; Frankel's exercise; Quality of life; Geriatrics

Outcome Measures

Primary Outcomes (1)

• Improve Balance

  The Berg Balance Scale is a 14-item clinical tool used to assess static and dynamic balance abilities in adults, especially older adults and patients with neurological or mobility impairments. It consist of 14 tasks scored from 0 to 4, with 0 = unable to perform and 4 = independent.

  Baseline and 8 week ( post-intervention)

Secondary Outcomes (1)

• Improve Quality of Life

  Baseline and week 8 ( post - treatment )

Study Arms (2)

Group A ( Cawthrone Cooksey exercise )

EXPERIMENTAL

Participants in Group A was received a structured treatment program including firstly head and eye movement then head torso movements aimed at improving balance and quality of life . Each session was last 50-60 minutes and was administered three times per week.

Other: Group A (Cawthrone Cooksey exercises)

Group B ( Frankel's exercises )

ACTIVE COMPARATOR

The exercise program was delivered to participants in supine , seated and standing positions. In these positions different body movements were performed to improve balance and quality of life . The treatment protocol consist of 50 - 60 minutes with three times a week .

Other: Group B ( Frankel's Exercises)

Interventions

Group A (Cawthrone Cooksey exercises) OTHER

Eyes and head movements, sitting, first slowly, then fast: Looking left to right; looking up and down; putting fingers to the face and observing them. Head turning left and right(first slowly then quickly) Head moving back and forth (slowly first then quickly Execute movements 4 and 5 while keeping eyes open Sitting head and torso movements: Rotating the shoulder joint Bending and raising an object in front of you and bend knees Placing object on the ground, lifting it above the head and then putting it back on the ground (the patient should gaze at the object during the exercise) After ten minutes warm up, eight week exercise will be performed.

Group A ( Cawthrone Cooksey exercise )

Group B ( Frankel's Exercises) OTHER

The exercise program was delivered in supine, seated, and standing positions. In supine, the patient performed 10 repetitions of alternating hip and knee flexion-extension, 10 repetitions of hip abduction-adduction with legs elevated, targeted leg placement to therapist-marked spots or therapist's hands, and passive hip stretching while lying flat. In seated, with back supported, the patient performed 10 alternating straight leg raises with controlled knee extension, heel slides to floor markers, heel/toe raises to designated targets, and sit-to-stand movements from the front edge of a chair without armrests. In standing, the patient performed weight shifting in stride stance, lateral stepping on floor markers, forward walking on a straight-line track, 360° pivot turns without lifting the feet, obstacle-avoidance walking, small-arc hip abduction-adduction, and small-arc hip flexion-extension kicks with straight, locked knees, all while following floor markings in the designated area.

Group B ( Frankel's exercises )

Eligibility Criteria

• Age: 50 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 50-80 years. The patient can follow simple commands and perform exercises as required by the rehabilitation process .
• MMSE \> 24 . Berg balance scale 21-40 or moderate imbalance . The capacity to stand for 30 seconds and walk six meters without help or only slight assistance Having not participated in a rehabilitation program in the previous six months

You may not qualify if:

• Refused to give consent . Any occurrence of illnesses like stroke throughout the research . Other neurological and musculoskeletal diseases affect balance (alzehmir, Parkinson,epilepsy) .
• Unstable cardiovascular conditions

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

Outdoor Department(OPD) of Madinah Teaching Hospital and Affiyat old age home , Faisalabad

Faisalābad, Punjab Province, 38000, Pakistan

Location

Related Publications (9)

• Manko G, Pieniazek M, Tim S, Jekielek M. The Effect of Frankel's Stabilization Exercises and Stabilometric Platform in the Balance in Elderly Patients: A Randomized Clinical Trial. Medicina (Kaunas). 2019 Sep 11;55(9):583. doi: 10.3390/medicina55090583.

  PMID: 31514453 BACKGROUND

• Kabuk A, Sevgin O. Comparison of the effects of mechanical hippotherapy and Cawthorne-Cooksey exercises in patients with multiple sclerosis: Randomized trial. Mult Scler Relat Disord. 2024 Jul;87:105697. doi: 10.1016/j.msard.2024.105697. Epub 2024 May 30.

  PMID: 38833975 BACKGROUND

• Espinoza-Araneda J, Bravo-Carrasco V, Alvarez C, Marzuca-Nassr GN, Munoz-Mendoza CL, Munoz J, Caparros-Manosalva C. Postural Balance and Gait Parameters of Independent Older Adults: A Sex Difference Analysis. Int J Environ Res Public Health. 2022 Mar 29;19(7):4064. doi: 10.3390/ijerph19074064.

  PMID: 35409748 BACKGROUND

• Dunsky A. The Effect of Balance and Coordination Exercises on Quality of Life in Older Adults: A Mini-Review. Front Aging Neurosci. 2019 Nov 15;11:318. doi: 10.3389/fnagi.2019.00318. eCollection 2019.

  PMID: 31803048 BACKGROUND

• Denkinger MD, Lukas A, Nikolaus T, Hauer K. Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review. Am J Geriatr Psychiatry. 2015 Jan;23(1):72-86. doi: 10.1016/j.jagp.2014.03.002. Epub 2014 Mar 15.

  PMID: 24745560 BACKGROUND

• Corna S, Nardone A, Prestinari A, Galante M, Grasso M, Schieppati M. Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit. Arch Phys Med Rehabil. 2003 Aug;84(8):1173-84. doi: 10.1016/s0003-9993(03)00130-8.

  PMID: 12917857 BACKGROUND

• Calisgan E, Talu B. The effect of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance after stroke: a randomized controlled trial. Top Stroke Rehabil. 2024 Oct;31(7):703-712. doi: 10.1080/10749357.2024.2318096. Epub 2024 Feb 19.

  PMID: 38373015 BACKGROUND

• Afrasiabifar A, Karami F, Najafi Doulatabad S. Comparing the effect of Cawthorne-Cooksey and Frenkel exercises on balance in patients with multiple sclerosis: a randomized controlled trial. Clin Rehabil. 2018 Jan;32(1):57-65. doi: 10.1177/0269215517714592. Epub 2017 Jun 19.

  PMID: 28629268 BACKGROUND

• Fallahzadeh Abarghuei A, Fadavi-Ghaffar M, Tousi S, Amini M, Salehi AR. Effect of cawthorne and cooksey exercises on balance and quality of life of 60 to 80 year- old individuals in Shiraz: A randomized clinical trial. Med J Islam Repub Iran. 2018 Aug 19;32:74. doi: 10.14196/mjiri.32.74. eCollection 2018.

  PMID: 30643749 BACKGROUND

Study Officials

• Dr Maryam Safdar

  The University of Faisalabad

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: This was single blinded study in which participants were unaware of their groups allocation. The group A and group B received identical- appearing interventions. Allocation was concealed from participants but known to investigator and data analysis
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: This study was a randomized clinical trial. 26 participants were taken according to inclusion and exclusion criteria from outpatient department (OPD) Of Madinah Teaching Hospital and Affiyat old age home Faisalabad through consecutive sampling. Written and verbal informed consent was taken from participant. Total sessions was 24. All population was received their respective treatment thrice a week for 60 minutes. Outcomes were taken at end of sessions according to scale readings that includes balance and quality of life through Berg balance scale and SF-36. Data was analyzed using SPSS 2023.

Study Record Dates

• First Submitted: August 20, 2026
• First Posted: August 25, 2026
• Study Start: September 1, 2025
• Primary Completion: November 30, 2025
• Study Completion: December 20, 2025
• Last Updated: August 25, 2026

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)