Effect of varied bimanual arm therapy on upper limb function, trunk function, balance, gait and cardiovascular endurance in stroke patients

Authors: Siddharth S. Mishra, Susan Jose

Published online:  18 December 2020

Abstract: Cerebrovascular accident-induced spasticity of one side of the body contributes to slowing down movement coordination, disturbed balance, and trunk control during gait that limits activities of daily living in stroke survivors. Bimanual therapy is an active, task-specific approach where limbs are constrained to act as a single unit by virtue of neural coupling. The present study aims to compare the effect of varied forms of bimanual arm therapy on upper limb function, trunk function, balance, gait, and cardiovascular endurance in stroke patients. Stroke patients (n=30) were randomly assigned to three treatment groups: Group A (loaded bimanual therapy with rhythmic auditory cueing); Group B (loaded bimanual therapy); and Group C (conventional therapy). Each group received 15 intervention sessions within 3 weeks. Results: an intragroup analysis showed a statistically significant difference (p<0.05) in WMFT, TIS, DGI, BBS, and 6MWD distance in all three groups individually. An intergroup analysis between the groups showed the highest improvements in WMFT, TIS, and MWD in Group A whereas Group B showed the highest improvement in TIS, BBS, and DGI. Hence, we conclude that loaded bimanual therapy with rhythmic auditory cueing leads to the maximum improvement in trunk function, balance, and gait. Loaded bimanual therapy demonstrated the maximum improvement in upper limb function and the distance covered in 6MWT compared to other groups.