Effects of two-handed task training on upper limb function of chronic hemiplegic patients after stroke.
Byung Il Yang, Bo Kyoung Song, Sang Mi Joung
PMID 28210051WHAT IT FOUND
Two chronic stroke patients practised everyday two-handed tasks for 12 sessions.
Both had larger and faster brain-to-hand responses and small hand-function gains, but this cannot show the training works.
Key findings
01In the patient with hemiplegic dominant right hand, motor-evoked potential amplitude rose from 0.13 mV before training to 0.27 mV after 12 sets, and latency fell from 24.23 ms to 23.03 ms.
02In the patient with hemiplegic non-dominant left hand, motor-evoked potential amplitude rose from 0.36 mV before training to 0.46 mV after 12 sets, and latency fell from 24.93 ms to 24.44 ms.
03Manual Function Test scores increased from 19.3 to 21 points in the dominant-hand patient and from 25 to 26 points in the non-dominant-hand patient, and both scores were maintained after 2 weeks and 3 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only two patients were studied, one with dominant-hand hemiplegia and one with non-dominant-hand hemiplegia, so the paper cannot show a general effect of two-handed task training. There was no control group or comparison treatment, so changes cannot be separated from time or repeated practice. The patients had no cognitive impairment on MMSE-K ≥24 and more than 58 points on the Fugl-Meyer upper extremity motor assessment, so the findings apply only to chronic stroke patients with relatively preserved upper limb motor function. Therapist support was offered as needed in every task, so the paper does not show the effect of the tasks alone or the amount of assistance required. Because all the tasks and therapist support were delivered together, the contribution of any single component cannot be separated. The paper reports raw motor-evoked potential and Manual Function Test values and graphs, not statistically tested effects.
The easy way to misread this
Do not conclude that two-handed task training caused the changes or works for chronic stroke patients. Only two patients received this training, and the paper did not include a comparison group.