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Effects of Alternating Bilateral Training Between Non-Paretic and Paretic Upper Limbs in Patients with Hemiparetic
Masashi Kumagai1, Shintaro Uehara2, Taichi Kurayama3
1Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Chiba; Department of Cognitive Behavioral Physiology, Chiba University Graduate School of Medicine, Chiba.
Objective:
To examine whether alternating training with both the non-paretic and paretic sides (alternating bilateral training), expecting trial-to-trial inter-limb transfer of training effects from the nonparetic to the paretic side, improves upper-limb motor performance in post-stroke patients, compared with unilateral training involving only the paretic side.
Design:
An assessor-blinded pilot randomized controlled trial.
Subjects:
Twenty-four right-handed post-stroke patients with hemiparesis.
Methods:
Participants were randomly allocated to either an alternating bilateral training group or a unilateral training group (n = 12/group). Participants underwent dexterity training of the paretic arm using the Nine-Hole Peg Test, completing 10 trials/day for 7 consecutive days. The alternating bilateral training group additionally performed alternating trials with the non-paretic limb. Performance change, assessed 1 day and 1 week after the 7-day training period, was compared between groups.
Results:
Although the improvement was comparable in both groups at both post-training time-points, a sub-analysis in which those with left hemiparesis and those with right hemiparesis were analyzed separately revealed potential benefits of the alternating bilateral training, specifically for those with left hemiparesis.
Conclusion:
Alternating bilateral training may augment training effects and improve upper-limb motor function in patients with left hemiparesis.
