Innovative motor learning training improves paretic arm function

Background and aims: Several studies have shown that bilateral training in post stroke upper‐limb rehabilitation is based on the premise that simultaneous movements of the nonparetic upper limb facilitate performance and recovery of paretic upper‐limb function through neural coupling effects. We hypothesized that if we use not only bilateral arm movements but also coordinate and combine them with leg movements, both symmetrically and asymmetrically using motor learning tasks, then this could be the effective strategy for recovering the functionality and motor control of the paretic arm. The aim of the study was to evaluate efficacy of the Upper and Lower Limbs Coordination Training Strategy. Methods: Sixty‐eight post‐stroke (> 6 months) hemiparetic subjects (Brunnstrom recovery stage ≥3) were randomly divided into 2 groups: Upper and Lower Limbs Coordination (ULLC) training group (n = 36) and Bilateral Upper Limb (BUL) training group (n = 32). We proposed the 8‐week intervention (5 sessions of 1 h each, per week). Motor performance was assessed before and after intervention included the Fugl‐Meyer assessment (FMA), the Wolf Motor Function Test (WMFT), Box and Block Test. Results: In both groups, the tests scores were significantly higher after the intervention, but the ULLC training group demonstrated greater improvement on the FMA test and the WMFT than the BUL training group. All assessments were executed by a blinded evaluator. Conclusions: The ULLC training strategy showed to be more effective than BUL training program in recovering the functionality and motor control of the paretic arm in post‐stroke (> 6 months) hemi‐paretic subjects.