Affiliations: [a] Shirley Ryan Ability Lab, Chicago, IL, USA | [b] Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA | [c] Interdepartmental Neuroscience Program, Northwestern University, Chicago, IL, USA | [d] Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA | [e] Department of Nursing, Rush University Medical Center, Chicago, IL, USA | [f] Department of Health Sciences and Research, Medical College of South Carolina, Charleston, SC, USA
Correspondence:
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Corresponding author: Mary Ellen Stoykov, PhD, OTR/L at Department of Physical Medicine and Rehabilitation, 710 N. Lakeshore Drive, Shirley Ryan Ability Lab, Arms & Hands Lab, 21st Floor, 355 East Erie, Chicago, IL 60611, United States. Tel.: +1 312 503 3106; Fax: +1 312 908 0741; E-mail: [email protected].
Abstract: Background:Bilateral priming, device assisted bilateral symmetrical wrist flexion/extension, is a noninvasive neuromodulation technique that can be used in the clinic. Objective:We examined the additive effect of bilateral motor priming and task specific training in individuals with severe upper limb hemiparesis. Methods:This is a parallel assignment, single-masked, randomized exploratory pilot study with three timepoints (pre-/post-intervention and follow up). Participants received either bilateral motor priming or health care education followed by task specific training. Sixteen participants who were at least 6 months post-stroke and had a Fugl Meyer Upper Extremity (FMUE) score between 23 and 38 were randomized. Our primary and secondary measures were Chedoke Arm & Hand Activity Index 9 (CAHAI-9) and the FMUE respectively. We determined changes in interhemispheric inhibition using transcranial magnetic stimulation. We hypothesized that improvement in the priming group would persist at follow up. Results:There was no between-group difference in the CAHAI. The improvement in the FMUE was significantly greater in the experimental group at follow up (t = 2.241, p = 0.045). Conclusions:Both groups improved in the CAHAI. There was a significant between-group difference in the secondary outcome measure (FMUE) where the bilateral priming group had an average increase of 10 points from pre-intervention to follow up.
