Bilateral movement therapy post-stroke: underlying mechanisms and review

Abstract

Aims Up to 66% of individuals with stroke never regain functional use of their upper extremities. Bilateral movement training (BMT) is a task-specific rehabilitation technique that has recently been investigated for its influence on upper extremity recovery in individuals post-stroke. BMT is thought to affect the hemiparetic upper extremity by a phenomenon referred to as cross education, or the cross transfer effect. Methods This article reviews the theoretical accounts underlying the cross transfer effect and explain the means by which BMT may facilitate recovery of function in the hemiparetic arm. The current research evidence supporting the use of BMT as a therapeutic approach to stroke rehabilitation is discussed, and implications for clinical practice and recommendations for further research are presented. Findings Evidence is emerging that BMT improves impairments and function in people with hemiparesis after stroke. The main limitations of existing research on BMT include small sample sizes, varying initial impairment levels, and lack of control groups. Conclusions Future research needs to establish which individuals are most likely to benefi tfrom BMT, as well as the optimal dose of BMT, and whether BMT can be used as an adjunct to existing rehabilitation approaches for upper extremity rehabilitation.