An experimental study was conducted in chronic stroke patients with POMA scores>18 and MMSE>24 in both male and female population, in Talegoan Dabhade. The subjects were made to understand the nature and purpose of the study. Every subject was given consent form prior to study. Subjects data, demographic factors, Outcome measures were taken pre and post the study.

Consists of 5; This is the control group, i.e this group continued their regular PT treatment (for reducing tone, for improving sensory function, interventions to improve flexibility and Joint integrity, interventions to improve and improve upper and lower limb function with gait training):

Rx; active movements upper limb, lower limb functional activities of the hand strengthening upper limb, lower limb tone inhibition, stretching, balance training.

The results obtained are in the favour of the study were proved by authors like Ariene Schmidt, 2012: “Poststroke Balance Improves with Yoga: A Pilot Study” which suggested that a group yoga-based rehabilitation intervention for people with chronic stroke has potential in improving Multiple poststroke variables. Group yoga may be complementary to rehabilitation, may be possible in medical-based and community-based settings, and may be cost-effective.Yoga may be especially effective in improving function poststroke, because it promotes coordination of complex movements, balance, strengthening, and breathing.⁸

Also, a systemic review by the Chapman Universities shows the studies of various authors and the improvement of Balance post Yoga-intervention.[11] yoga has shown to improve strength and muscle force.¹¹ In regards to the stroke population, increased muscle force may allow for greater musculoskeletal control leading to better balance and mobility.[11]

In the chair pose, UTKATSANA (fig 3) there is an activation of gluteus maximus along with counterbalancing forward tilt of the pelvis for stabilizing the trunk structures.[12] Also, there is an activation of longissmus thoracis and external oblique muscles. Reduction in electromyographic anticipatory postural activation was also noted in lattismus dorsi and external oblique muscles of the affected side in a study by Suruliraj Karthikbabu et al.[13] Also, the study suggests that leg muscles may assist in stabilizing the trunk in the antero-posterior direction whereas lateral sitting balance almost completely depends on trunk muscles. UTKATASANA also targets generally the Quadriceps, Hamstrings, Gluteus Maximus, Gastrocnemius, Tibialis Anterior, Soleus and other muscles in lower extremities. Like in the mountain pose, TADASANA, co-contracion of Rectus Ab0dominis and Longissmus Thoracis was seen to stabilize the lumbopelvic hip segment. The two mountain poses with hands up (hip flexed and calf raised) are designed to elevate the back, open the pelvic region, and compress the ribcage to increase stabilization.[14]

In the warrior pose, Trikonasa, the hip and knee of the dominant and non-dominant sides were respectively flexed and extended, while the spine was kept extended. When the front leg was flexed, the back-leg Gluteus Maximus was activated to extend and externally rotate the hip producing a very high activity level. This pose could be an effective tool for increasing Gluteus MAximus strength. But, also with spine extension there was low level activation of Longissmus THoracis, which would develop endurance and reduce fatigue. [12] This could be a reason why the paitents withstand the nudged component of POMA.

In the BHUJANGASANA pose, the hip is extended and internally rotated, and the trunk is hyper-extended. This exercise also targets the Gluteus maximus and lower extremity improving the single-limb support component. [15]This back extension pose stretches the anterior aspect of trunk muscles and mobilizes the posterior trunk musculature. Also, there is a high activation of External Oblique Abdminis and upper and lower fibres of Rectus Abdominis. Also, since the pose in maintained by the upper extremity, theres co-contraction of biceps, triceps and the shoulder musculature, improving upper limb stability.

Medical Yoga Therapy by Ina Stephens[16] claims that yoga practices seem to be effective by bringing the parasympathetic and sympathetic systems into balance (often by increasing parasympathetic tone and decreasing sympathetic firing), and does this in large part by increasing GABA activity [17]. Studies have shown that GAB Aergic inhibitory interneurons result in cortical inhibition which has been implicated in improved cognitive performance and enhanced emotional regulation capabilities [18]. Multiple studies have shown that the practice of yoga and meditation may work as well as other therapies in increasing GABA levels in the brain [19]

In POMA, in the balance components, patients have shown an improvement in the nudged [6] component, turning 360 degrees and continuous steps [8], this could be due to an improvement in the muscles controlling the ankle strategy. According to Ki Heyon Park et al,The effects of ankle strategy exercises on unstable surfaces on dynamic balance and changes in the COP[20], An ankle joint strategy is one in which the balance is maintained through a little movement with appropriately four actions that occur at the ankle joint; dorsiflexion, plantar flexion, inversion, and eversion. To control trunk postures, the central nervous system receives information from the feet and integrates the surrounding environment to receive information using ascending neural pathways[21]. Ankle joint plantar flexion is regarded as a core control mechanism in standing[22]^. Involving the gastrocnemius, the soleus, and the tibialis anterior, plantar flexion serves the function of balance control in response to ground reaction forces[23] and plays an important role in gait efficiency. As a solution for balance problems, the treatment of abnormal muscular contraction or proprioceptive deficit through the reeducation of ankle movements has been reported to be important[24].

Also, in Gait component in Yoga, step symmetry, step continuity and path have shown improvement, due to the improvement in Hip abductor strength and lateral trunk musculature strength as seen in Virabhadrasana, BHujangasana and setubhandasana.