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Bimanual Coordination Functions between Paretic and Nonparetic Arms: A Systematic Review and Meta-analysis
Rye Kyeong Kim1, Nyeonju Kang1
1Division of Sport Science & Sport Science Institute, Incheon National University, Incheon, South Korea; Neuromechanical Rehabilitation Research Laboratory, Incheon National University, Incheon, South Korea.
Background:
Bimanual coordination is essential for performing many everyday interlimb actions that require successful spatiotemporal interactions between the 2 arms. This systematic review and meta-analysis investigates bimanual coordination function of the upper extremities in patients with stroke.
Methods:
Seventeen studies that compared bimanual coordination functions in patients with stroke and age-matched healthy controls qualified for this meta-analysis. We categorized 25 comparisons from the 17 qualified studies into 6 types of bimanual actions based on 3 task constraints: (1), symmetry versus asymmetry movements, (2) parallel versus cooperative movements, and (3) independent goals versus a common goal.
Results:
Random effects meta-analysis revealed that patients with stroke had impaired kinematic (Hedges's g = -1.232 and P < .0001) and kinetic (Hedges's g = -.712 and P = .001) control of bimanual coordination as compared with the age-matched healthy controls. The moderator variable analysis on the 6 types of bimanual actions showed that bimanual coordination impairments after stroke appeared while performing both asymmetrical bimanual movements and symmetrical bimanual movements to achieve a common goal. Moreover, we observed a potential relationship between greater time since stroke onset and increased interlimb coordination impairments for chronic patients.
Conclusions:
These findings suggest that restoring interlimb coordination functions after stroke may be a crucial rehabilitation goal for facilitating progress toward stroke motor recovery.
