Tehran University of Medical Sciences Journal of Modern Rehabilitation 2538-385X 0 - 2026 06 14 1485 1485 Faezeh Kouhestani Dehaghi Department of Physiotherapy, School of Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran Majid Ghasemi Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Tayebeh Roghani Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Ehsan Ghasemi Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2025 12 28 2026 05 06 Background: Stroke is a leading cause of adult disability. Spasticity is a neurological condition that occurs secondary to stroke and affecting the patient's quality of life. This study designed to compare the effect of reactive and proactive exercises on spasticity in people with stroke. Materials and methods: In this single-blind clinical trial study, 30 people with stroke were randomly divided into three groups: control, reactive, and proactive, of which 27 patients completed the study. These people were treated for 12 sessions for 4 weeks (three times a week). The control group received conventional exercises, the reactive group received conventional exercises plus reactive exercises, and the proactive group received conventional exercises plus proactive exercises. The outcomes were clinical outcome of spasticity in baseline and neural properties that respectively evaluated using the Modified Modified Ashworth Scale and H-reflex latency and Hmax/Mmax ratio. All statistical analyzes were performed using SPSS version 20. Results: In H-reflex latency (F = 0.404, P = 0.672, ηp² = 0.033) and Hmax/Mmax ratio (F = 0.878, P = 0.429, ηp² = 0.071) there were no significant differences between groups. Conclusions: Intergroup comparisons did not show a significant advantage in favor of the use of proactive and reactive exercises on neural properties of spasticity compared to conventional exercises alone. https://jmr.tums.ac.ir/index.php/jmr/article/view/1485