Article

Bilateral training in poststroke upper-limb rehabilitation is based
on the premise that simultaneous movements of the nonparetic upper limb
facilitate performance and recovery of paretic upper-limb function through neural
coupling effects. OBJECTIVE: To determine whether the degree of coupling between
both hands is higher after bilateral than after unilateral training and control
treatment. METHODS: In a single-blinded randomized controlled trial, we
investigated rhythmic interlimb coordination after unilateral (mCIMT) and
bilateral (mBATRAC) upper-limb training and a dose-matched control treatment
(DMCT) in 60 patients suffering from stroke. To this end, we used a series of
tasks to discern intended and unintended coupling effects between the hands. In
addition, we investigated the control over the paretic hand as reflected by
movement harmonicity and amplitude. All tasks were performed before and after a
6-week intervention period and at follow-up 6 weeks later. RESULTS: There were no
significant between-group differences in change scores from baseline to
postintervention and from postintervention to follow-up with regard to interlimb
coupling. However, the mBATRAC group showed greater movement harmonicity and
larger amplitudes with the paretic hand after training than the mCIMT and DMCT
groups. CONCLUSIONS: The degree of coupling between both hands was not
significantly higher after bilateral than after unilateral training and control
treatment. Although improvements in movement harmonicity and amplitude following
mBATRAC may indicate a beneficial influence of the interlimb coupling, those
effects were more likely due to the particular type of limb movements employed
during this training protocol.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS