EFFECTS OF ALTERNATING BILATERAL TRAINING BETWEEN NON-PARETIC AND PARETIC UPPER LIMBS IN PATIENTS WITH HEMIPARETIC STROKE: A PILOT RANDOMIZED CONTROLLED TRIAL

Objective: To examine whether alternating training with both the non-paretic and paretic sides (alter nating bilateral training), expecting trial-to-trial inter-limb transfer of training effects from the non-paretic to the paretic side, improves upper-limb motor performance in post-stroke patients, compa red with unilateral training involving only the pare tic side. Design: An assessor-blinded pilot randomized con trolled trial. Subjects: Twenty-four right-handed post-stroke pa tients with hemiparesis. Methods: Participants were randomly allocated to either an alternating bilateral training group or a unilateral training group (n = 12/group). Partici pants 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 al ternating trials with the non-paretic limb. Perfor mance change, assessed 1 day and 1 week after the 7-day training period, was compared between groups. Results: Although the improvement was compara ble 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 se parately revealed potential benefits of the alterna ting bilateral training, specifically for those with left hemiparesis. Conclusion: Alternating bilateral training may aug ment training effects and improve upper-limb mo tor function in patients with left hemiparesis.