title: 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 (I(2)=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.
authors.affiliation: Motor Behavior Laboratory, Center for Exercise Science, University of Florida, Gainesville, Florida 32611, USA. jcaura@hhp.ufl.edu
authors.forename: James H
authors.initials: JH
authors.lastname: Cauraugh
authors.forename: Neha
authors.initials: N
authors.lastname: Lodha
authors.forename: Sagar K
authors.initials: SK
authors.lastname: Naik
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Summers
mesh_terms: D000368:Aged; D019992:Databases as Topic / Q000592:standards; D004576:Electromyography; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009068:Movement / Q000502:physiology*; D018579:Patient Selection; D012106:Research / Q000592:standards; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation