Article

OBJECTIVES: To investigate effects of bilateral training (BT) on ipsilesional arm
dexterity and activity limitation; to explore clinical and demographic factors
that influence training effects; and to explore relationships between
contralesional and ipsilesional recovery. DESIGN: Single-blind randomized
controlled trial with outcome assessment at baseline, postintervention (6 wk),
and follow-up (18 wk). SETTING: Inpatient acute and rehabilitation hospitals.
PARTICIPANTS: Participants were randomized to a BT group in which training
involved the ipsilesional and contralesional arms (n=56) or control training
involving the contralesional arm only (n=50). INTERVENTIONS: Supervised BT or
control training for 20 minutes on weekdays over a 6-week period using a
standardized program. MAIN OUTCOME MEASURES:
Upper limb activity limitation:
Action Research Arm Test; and dexterity: Nine-Hole Peg Test (9HPT). RESULTS:
Lower baseline scores were found for the ipsilesional arm on both measures
compared with published normative values. The BT group demonstrated significantly
greater change in dexterity (P=.03) during the intervention phase at 0 to 6 weeks
(.06+/-.07pegs/s) compared with the control group (.02+/-.02pegs/s). The effect
was lost for overall recovery at 0 to 18 weeks (P=.93). Younger participants
(age</=68y) performed the 9HPT faster at baseline than older participants (P=.04)
and demonstrated greater overall recovery with BT than older participants
(P=.04). There was no significant correlation between ipsilesional and
contralesional recovery. CONCLUSIONS: The study suggests that BT may lead to
clinically small improvements in ipsilesional performance of fine, rapid
dexterity tasks. Younger participants responded better to BT. There was no
relationship between contralesional and ipsilesional recovery, suggesting that
different causes and recovery mechanisms may exist.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS