Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke

TLDR

Chronic upper‑extremity hemiparesis remains a leading cause of functional disability after stroke. The study tested whether bilateral arm training with rhythmic auditory cueing (BATRAC) improves motor function in the hemiparetic arm of stroke patients. Six weeks of BATRAC, delivered in four 5‑minute sessions three times weekly using a custom arm‑training machine, was evaluated in 14 chronic stroke patients (median 30 months post‑stroke). Six weeks of BATRAC produced significant, durable improvements in upper‑extremity motor performance (Fugl‑Meyer, Wolf Motor Function Test, UMARS), isometric strength, and range of motion, with benefits largely maintained eight weeks post‑training.

Abstract

Background and Purpose —Chronic upper extremity hemiparesis is a leading cause of functional disability after stroke. We investigated the hypothesis that bilateral arm training with rhythmic auditory cueing (BATRAC) will improve motor function in the hemiparetic arm of stroke patients. Methods —In this single group pilot study we determined the effects of 6 weeks of BATRAC on 14 patients with chronic hemiparetic stroke (median time after stroke, 30 months) immediately after training and at 2 months after training. Four 5-minute periods per session (3 times per week) of BATRAC were performed with the use of a custom-designed arm training machine. Results —The patients showed significant and potentially durable increases in the following: Fugl-Meyer Upper Extremity Motor Performance Test of impairment ( P <0.0004), Wolf Motor Function Test (performance time measure, P <0.02), and University of Maryland Arm Questionnaire for Stroke measuring daily use of the hemiparetic arm ( P <0.002). Isometric strength improved in elbow flexion ( P <0.05) and wrist flexion ( P <0.02) for the paretic arm and in elbow flexion ( P <0.02) and wrist extension ( P <0.02) for the nonparetic arm. Active range of motion improved for paretic-side shoulder extension ( P <0.01), wrist flexion ( P <0.004), and thumb opposition ( P <0.002), and passive range of motion improved for paretic wrist flexion ( P <0.03). Conclusions —Six weeks of BATRAC improves functional motor performance of the paretic upper extremity as well as a few changes in isometric strength and range of motion. These benefits are largely sustained at 8 weeks after training cessation.