Affiliations: University of Florida, Gainesville, FL, USA | University of Tasmania, Hobart, Tasmania,
Australia
Note: [] Corresponding author: James H. Cauraugh, Motor Behavior
Laboratory, Applied Physiology and Kinesiology Department, University of
Florida, Gainesville, FL 32611, USA. Tel.: +1 352 392 0584, ext. 1273; Fax: +1
352 392 0316; E-mail: jcaura@hhp.ufl.edu
Abstract: Background: The current treatment intervention study determined the
effect of coupled bilateral training (i.e., bilateral movements and
EMG-triggered neuromuscular stimulation) and resistive load (mass) on upper
extremity motor recovery in chronic stroke. Methods: Thirty chronic stroke subjects were randomly assigned
to one of three behavioral treatment groups and completed 6 hours of
rehabilitation in 4 days: (1) coupled bilateral training with a load on the
unimpaired hand, (2) coupled bilateral training with no load on the unimpaired
hand, and (3) control (no stimulation assistance or load). Results: Separate mixed design ANOVAs revealed improved motor
capabilities by the coupled bilateral groups. From the pretest to the posttest,
both the coupled bilateral no load and load groups moved a higher number of
blocks and demonstrated more regularity in the sustained contraction task.
Faster motor reaction times across test sessions for the coupled bilateral load
group provided additional evidence for improved motor capabilities. Conclusions: Together these behavioral findings lend support
to the contribution of coupled bilateral training with a load on the unimpaired
arm to improved motor capabilities on the impaired arm. This evidence supports
a neural explanation in that simultaneously moving both limbs during stroke
rehabilitation training appears to activate balanced interhemispheric
interactions while an extra load on the unimpaired limb provides stability to
the system.
Keywords: Chronic stroke, neurological rehabilitation, bilateral movement training, EMG-triggered neuromuscular stimulation, motor recovery
