Pranayama for Stroke Recovery

INTERVENTION: Intervention1: Pranayama: Core components Breath awareness and regulation Slow, deep diaphragmatic breathing Alternate nostril breathing (Anulom Vilom) Optional OM chanting Cool down rest Frequency, Duration, and Dose Intervention period 5 consecutive days. Maximum supervised sessions per day Up to 5 sessions per day depending on the patients ability and tolerance Session length: Each session up to 15 minutes, including preparation and rest The actual number of sessions and components used per day will be tailored to patient capacity all deviations will be recorded Control Intervention1: Standard stroke care: Standard stroke care in the patient and out patient services CONDITION: Health Condition 1: I633‐ Cerebral infarction due to thrombosis of cerebral arteries PRIMARY OUTCOME: Feasibility Screening to enrolment rate, recruitment rate ; Adherence sessions completed sessions planned (dose received) ; Retention to Day 5 endpoint ; Acceptability AIM IAM FIM scores ; Change in HRV parameters from Day 1 to Day 5Timepoint: on day 5 SECONDARY OUTCOME: Change in HR BP RR oxygen saturation from Day 1 to Day 5Timepoint: day 5 Change in NRS stress anxiety low mood sleep qualityTimepoint: Day 5 INCLUSION CRITERIA: Adults aged 18 years or above Clinically and radiologically confirmed ischemic stroke Stroke onset within less than 90 days acute to early subacute stage Stable and considered fit for participation by the treating neurologist Able to follow simple verbal instructions, with the ability to sit or remain in a semireclined position for 10 to 15 minutes no severe dyspnea respiratory distress Willingness to provide written informed consent patient or legally acceptable representative