A Lex E Q van Delden1, Peter J Beek2, Melvyn Roerdink3, Gert Kwakkel4, C Lieke E Peper3. 1. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands l.van.delden@vu.nl. 2. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands School of Sport and Education, Brunel University, London, UK. 3. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands. 4. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, Netherlands Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, Netherlands Department of Neurorehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands.
Abstract
BACKGROUND: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.
RCT Entities:
BACKGROUND: 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.
Authors: Anthony M Dutcher; Khangy V Truong; Dallas D Miller; Rachel P Allred; Evan Nudi; Theresa A Jones Journal: Behav Brain Res Date: 2020-09-14 Impact factor: 3.332
Authors: Anne Schwarz; Miguel M C Bhagubai; Saskia H G Nies; Jeremia P O Held; Peter H Veltink; Jaap H Buurke; Andreas R Luft Journal: J Neuroeng Rehabil Date: 2022-01-12 Impact factor: 5.208