By performing simple activities of daily living such as eating (using a cup and spoon), dressing (wearing and taking off a shirt), using a belt, personal hygiene (using a towel , combing, tooth brushing) and other activities using household materials like bottle, book etc. Each of these activities will perform for 5 repetitions. Tasks will be perform with the participants seating in front of the table placed at a suitable height where objects related to the intervention are arranged. The level of difficulty to the patient will increase slowly day by day by assigning the tasks above the patient’s capacity and by increase the distance between the object by which task should be carried out and reducing the size of the object and by decreasing the time to carry out a task. A rest interval of 5mins will be given whenever it is required by the patient in one exercise period. Along with task-oriented therapy, conventional therapy sessions will be conducted to the patient’s which consisted of passive and active assisted mobilization of the upper limbs; exercises with resistance or assistance from balls, elastic bands and dumbbells; active assisted mobility exercises of the upper limb and fingers in a sitting position; moving objects horizontally on a table; elevation and superposition of objects in the vertical plane; and biomechanical tasks that simulated flexion–extension and abduction–adduction of the shoulder and flexion–extension of the wrist and fingers.

 Group B receives Brunnstrom Movement Therapy with Conventional Therapy

 1. Imitation Synkinesis - Performance of difficult movements by performing the same movement on the unaffected side 

 2. Proximal traction response - A stretch of the flexor muscles of one of the joints of upper limb evokes or facilitates contraction of flexor muscles of all the other joints resulting in a total shortening of the limb

 3. Wrist fixation for Grasp a. Synergy influence on wrist muscles, using synergy in both flexors and extensors b. Wrist Functioning Position the wrist in extension. Resist active extension movements at the proximal portion of the patient’s arm or to his closed fist. c. Activation of wrist extensor muscles Stabilize the wrist in extension. Stimulate the extensor carpi radialis longus as it crosses the wrist joint. While applying percussion over the proximal portion of the wrist extensor muscles, simultaneously ask the patient to squeeze. When squeezing, wrist support is withdrawn and the patient is asked to hold the contraction. Provide repeated percussion movements. d. Wrist stabilization for grasp, elbow flexed. Repeat the entire process with the elbow slightly flexed. e. Hyperactive wrist extensor muscles. In exceptional cases, practice relaxation by flexing the elbow. 

 4. Release of grasp and elicitation of extensor reflexes a. Patient and therapist sit facing each other. Thumb is pulled out of the palm by a grip around the muscles of the thenar eminence, and the forearm is supinate passively. b. Supinate and pronate the forearm slowly. The movement is repeated to emphasize supination. Cutaneous stimulation over the dorsum of the wrist and hand is given to the supinated forearm. c. Swatting of the fingers -Therapist uses a free hand for rapid, distally directed movements over the proximal phalanges of the patient’s affected hand. d. Eliciting stretch reflexes in the finger extensor muscles. Along with Brunnstrom therapy, conventional therapy sessions will be conducted.