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.