Article

Upper extremity hemiparesis is the most common poststroke disability.
Longitudinal studies have indicated that 30% to 66% of stroke survivors do not
have full arm function 6 months poststroke. One promising treatment approach is
bilateral training. To date, no randomized, blinded study of efficacy comparing 2
groups (bilateral training vs unilateral training) using analogous tasks has been
performed in chronic stroke survivors with moderate upper extremity impairment.
OBJECTIVE: To compare the effectiveness of bilateral training with unilateral
training for individuals with moderate upper limb hemiparesis. The authors
hypothesized that bilateral training would be superior to unilateral training in
the proximal extremity but not the distal one. METHODS:
Twenty-four subjects
participated in a randomized, single-blind training study. Subjects in the
bilateral group (n = 12) practiced bilateral symmetrical activities, whereas the
unilateral group (n = 12) performed the same activity with the affected arm only.
The activities consisted of reaching-based tasks that were both rhythmic and
discrete. The Motor Assessment Scale (MAS), Motor Status Scale (MSS), and muscle
strength were used as outcome measures. Assessments were administered at baseline
and posttraining by a rater blinded to group assignment. RESULTS: Both groups had
significant improvements on the MSS and measures of strength. The bilateral group
had significantly greater improvement on the Upper Arm Function scale (a subscale
of the MAS-Upper Limb Items). CONCLUSION: Both bilateral and unilateral training
are efficacious for moderately impaired chronic stroke survivors. Bilateral training may be more advantageous for proximal arm function.

Langue : ANGLAIS