Generalization of a modified form of repetitive rhythmic bilateral training in stroke

ObjectiveTo determine if a modified form of repetitive rhythmic bilateral training will generalize to two reach to target tasks.SettingTesting and training were performed at the Brain Rehabilitation Research Center, Malcom Randall VAMC in Gainesville, Florida.SubjectsFourteen subjects with chronic stroke completed this study: 9 male, 5 female, mean age 64.4 years, and a mean of 5.5 years post-stroke.InterventionModified Bilateral Arm Training with Rhythmic Auditory Cueing (modBATRAC) was performed 4 sessions/week of 2.25 h/session for 2 weeks.Main measuresEnd-point kinematic measures; hand path curvature, time to peak velocity, peak velocity, smoothness of the curve and acceleration using the Vicon motion analysis system during two reach to target tasks: (1) similar spatial demands (2) dissimilar spatial demands. An individual analysis was performed to investigate if there was any pattern of responding. Additionally, correlation analyses of kinematic and functional measures taken pre- and post-test were performed.ResultsImprovements were found at post-test for hand path curvature, smoothness of the curve, and peak velocity and were equivalent across two reach to target tasks.DiscussionGeneralization was found for both reach to target tasks for end-point kinematic aspects (PV, HPC, and number of Peaks) during modBATRAC training. There was a positive correlation with the significant kinematic variables (HPC and PV) and the functional measures used pre- and post-test in this study. This suggests that generalization may be possible through the practice of basic coordinated movements after stroke. These basic movements may provide the building blocks for more complex movement behaviors.