Coupled Bimanual Training Using a Non-Powered Device for Individuals with Severe Hemiparesis: A Pilot Study

Area of Science:

• Neurorehabilitation
• Biomechanics
• Motor Control

Background:

• Severe hemiparesis post-stroke limits arm movement training options.
• The Bimanual Arm Trainer (BAT) facilitates coupled bimanual training of shoulder external rotation.
• Bimanual training leverages contralesional cortical activity to aid motor recovery in the affected arm.

Purpose of the Study:

• To evaluate the safety and feasibility of the non-powered Bimanual Arm Trainer (BAT).
• To assess the BAT's efficacy in facilitating motor recovery for individuals with severe hemiparesis.

Main Methods:

• Nine participants with severe hemiparesis underwent a six-week training program using the BAT.
• Training involved 45-minute sessions, twice weekly, focusing on coupled bimanual shoulder external rotation.
• Participants were assessed pre- and post-intervention using Fugl-Meyer and Wolf Motor Function Test.

Main Results:

• The Bimanual Arm Trainer (BAT) training was well-tolerated with no adverse events reported.
• Significant improvements were observed in the upper extremity Fugl-Meyer score (effect size 0.89).
• Improvements in active range of motion and reduced flexor synergy patterns were noted, alongside some gains in task performance time.

Conclusions:

• The Bimanual Arm Trainer (BAT) is a safe and feasible intervention for facilitating motor recovery.
• This device shows promise for individuals with severe hemiparesis, improving both trained and untrained movements.