Effects of Alternating Bilateral Training Between Non-Paretic and Paretic Upper Limbs in Patients with Hemiparetic Stroke: A Pilot Randomized Controlled Trial.
Masashi Kumagai, Shintaro Uehara, Taichi Kurayama and 6 others
PMID 36173326WHAT IT FOUND
Alternating training between hands did not improve paretic hand speed more than paretic-only training overall.
However, it significantly improved non-paretic hand speed. Subgroup analysis suggested alternating training helped paretic hand speed only in patients with left hemiparesis, but this requires confirmation.
Key findings
01There was no significant difference between alternating bilateral training and unilateral training for improving paretic hand speed at post-training or follow-up.
02Alternating bilateral training resulted in significantly greater improvement in non-paretic hand speed compared to unilateral training at both post-training and follow-up.
03In a subgroup analysis, alternating bilateral training significantly improved paretic hand speed in patients with left hemiparesis, but not in those with right hemiparesis.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was a pilot with a very small sample size (24 participants), limiting statistical power. The subgroup analysis suggesting benefit for left hemiparesis involved very small numbers and is hypothesis-generating only. Participants had mild-to-moderate impairment (NHPT time 30-60s), so results do not apply to those with severe hand dysfunction. Improvements in the specific training task (NHPT) did not generalize to other dexterity tasks (Purdue Pegboard, Box and Block).
Declared interests
The authors declared no conflicts of interest. The study was supported by a grant from the Japan Society for the Promotion of Science (KAKENHI).
The easy way to misread this
Do not recommend alternating bilateral training to improve paretic hand function based on this study. The primary outcome was null, and the positive finding for left hemiparesis is a small subgroup result that needs confirmation in a larger trial.