Bilateral movement training and stroke motor recovery progress: A structured review and meta-analysis

Abstract

The purpose was to conduct a structured review and meta-analysis to determine the cumulative effect of bilateral arm training on motor capabilities post stroke. Forty-eight stroke studies were selected from three databases with 25 comparisons qualifying for inclusion in our meta-analysis. We identified and coded four types of bilateral arm interventions with 366 stroke patients. A random effects model using the standardized mean difference technique determined a large and significant effect size (0.734; SE = 0.125), high fail-safe N (532), and medium variability in the studies (I2 = 63%). Moderator variable analysis on the type of bilateral training revealed two large and significant effects: (a) BATRAC (0.842; SE = 0.155) and (b) coupled bilateral and EMG-triggered neuromuscular stimulation (1.142; SE = 0.176). These novel findings provide strong evidence supporting bilateral arm training with the caveat that two coupled protocols, rhythmic alternating movements and active stimulation, are most effective.

Participant perceptions of use of CyWee Z as adjunct to rehabilitation of upper-limb function following stroke

“…Another participant was now able to push her manual wheelchair with both hands, thus going straight. This finding was not surprising because bilateral therapy has proven efficacy in functional recovery of the upper limb following stroke [34][35][36][37].…”

Bilateral upper-limb rehabilitation after stroke using a movement-based game controller

“…First, the unaffected side can support and assist the affected side in a bilateral manner by using the handlebar. Bilateral therapy has proven to be effective in functional recovery of the upper limb [20][21]. Second, rotation of the CyWee Z results in synchronous bilateral gross motor movements with the handlebar, whereas while the CyWee Z is held in one hand without the handlebar, only limited wrist movement is needed to control the cursor.…”

“…Moreover, strong evidence exists that bilateral training is effective in functional recovery of the upper limb [20][21]. Summers et al suggest that bilateral synchronous movement therapy is more effective than similar unilateral training [22].…”

Relationship between Physical Activity and Stroke: Review From Different Meta Analytical Studies

“…The effect is statistically significant only for men, not for women. 20 had done a Structured Review and Meta-Analysis on Bilateral Movement Training and Stroke Motor Recovery Progress from 48 stroke studies with 366 stroke patients. A random effects model using the standardized mean difference technique determined a large and significant effect size (0.734; SE = 0.125), high fail-safe N (532), and medium variability in the studies (I2 = 63%).…”