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ISSN: 2329-9096

International Journal of Physical Medicine & Rehabilitation
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Research Article

Coupled Bimanual Training Using a Non-Powered Device for Individuals with Severe Hemiparesis: A Pilot Study

Preeti Raghavan1*, Viswanath Aluru1, Sina Milani1, Peter Thai1, Daniel Geller1, Seda Bilaloglu1, Ying Lu2 and Donald J Weisz3

1Department of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA

2Promotion of Research Involving Innovative Statistical Methodology (PRIISM), Steinhardt School of Culture, Education, and Human Development, New York, NY, USA

3Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA

*Corresponding Author:
Preeti Raghavan
Rusk Rehabilitation, New York University School of Medicine 240 E 38th Street
17th Floor, New York, NY 10016, USA
Phone: 212-263-0344
Fax: 212-263-2683
E-mail: [email protected]

Received date: March 22, 2017; Accepted date: April 21, 2017; Published date: April 28, 2017

Citation: Raghavan P, Aluru V, Milani S, Thai P, Geller D, Bilaloglu S, et al. (2017) Coupled Bimanual Training Using a Non-Powered Device for Individuals with Severe Hemiparesis: A Pilot Study. Int J Phys Med Rehabil 5:404. doi: 10.4172/2329-9096.1000404

Copyright: © 2017 Raghavan P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: Few options exist for training arm movements in participants with severe post-stroke hemiparesis who have little active range of motion. The purpose of this study was to test the safety and feasibility of training with a non-powered device, the Bimanual Arm Trainer (BAT), to facilitate motor recovery in individuals with severe hemiparesis. The BAT enabled coupled bimanual training of shoulder external rotation, which is reduced in individuals with severe post-stroke hemiplegia. The rationale for bimanual training was to harness contralesional cortical activity to drive voluntary movement in the affected arm in patients who could barely perform unimanual movements.

Methods: Nine participants with post-stroke hemiparesis, preserved passive range of motion and Modified Ashworth score of <3 in the shoulder and elbow joints, trained with the device for 45 minutes, twice a week for six weeks, and were assessed pre- and post-training.

Results: All participants tolerated the training and no adverse events were reported. Participants showed significant improvement in the upper extremity Fugl-Meyer score post-training with an effect size of 0.89. Changes in the flexor synergy pattern accounted for 64.7% of the improvement. Improvement in active range of motion in the paretic limb occurred for both trained and untrained movements. Some participants showed improvement in the time taken to perform selected tasks on the Wolf Motor Function Test post-training.

Conclusion: The results demonstrate the safety and feasibility of using the Bimanual Arm Trainer to facilitate motor recovery in individuals with severe hemiparesis.

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