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Abstract Background : For activity of daily living, person should be able to maintain and adopt various postures, react to external disturbances and use automatic postural responses. After stroke some or all of these tasks become difficult. Daily living requires balance and walking ability while performing other tasks. Purpose: To investigate the difference between the effect of aquatic dual task training and land based dual task training for improving postural stability in stroke patients. Methods: thirty male stroke patients referred medically, ages ranged from 45:60 years old, were assigned into two equal groups (group A and B): group A received land based dual task training while group B received aquatic dual task training. The duration of treatment was four weeks, three times weekly, day after day forty minutes per session and two weeks as a follow up. Patients were assessed using Biodex balance system (bilateral postural stability test) and clinical tests (timed up and go, functional reach test). Results: Within group comparison, each group showed a significant improvement of measured variables with greater improvement in all variables in favor of group B. Between group comparison, there was a significant difference in timed up and go test and functional reach test, however, there was no significant difference in stability index between groups. Conclusion: The use of Aquatic dual task training, and based dual task training can effectively improve postural stability in stroke patients. It appears to be that aquatic training offered a greater improvement of postural stability in stroke patients |