{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T20:22:36Z","timestamp":1787862156686,"version":"build-2784847793"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2020YFC2005700"],"award-info":[{"award-number":["2020YFC2005700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stroke is a leading cause of long\u2010term disability in adults, with upper limb hemiparesis being a common impairment. Traditional training is mostly aimed at paralyzed limbs, but the effect of bilateral training is still unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study explores the influence and mechanism of unilateral and bilateral rhythmic task training on the rehabilitation of stroke patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This was a double\u2010blind randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010six patients were randomly assigned to the bilateral group or to the unilateral group. The bilateral group engaged in repetitive training involving both arms and distal hand movements, while the unilateral group focused on the affected arm. Evaluations were performed before treatment and immediately after treatment. The outcome measures included Fugl\u2010Meyer Upper Extremity (FMA\u2010UE), the average electromyographic values of a total of 16 muscle groups on both the unaffected and affected sides (with 8 muscle groups on each side) during maximum voluntary isometric contraction, as well as the active range of motion (ROM). Changes in interhemispheric inhibition (IHI) were assessed using transcranial magnetic stimulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Post\u2010treatment assessments indicated that the FMA\u2010UE scores significantly increased in both groups, with the bilateral group exhibiting more pronounced improvements (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.130). Specifically, compared to their pre\u2010treatment states, the bilateral group showed statistically significant differences in the maximum EMG amplitudes of the anterior deltoid (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.204) and wrist flexor muscles (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.308) on the affected side, with greater gains than the unilateral group. Additionally, the maximum EMG amplitudes of the biceps brachii (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.124) and wrist extensors (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.153) on the unaffected side were significantly enhanced in the bilateral group. In terms of active ROM, the bilateral group demonstrated significant improvements in shoulder flexion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.142) and wrist flexion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.149), which surpassed those observed in the unilateral group. Furthermore, a significant reduction in IHI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023; \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.196) was observed, which was positively correlated with FMA\u2010UE scores following bilateral training (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.85,\n                      <jats:italic>p\u2009&lt;<\/jats:italic>\n                      \u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bilateral training is more effective than unilateral training in enhancing upper limb function and may contribute to balancing IHI in stroke recovery patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70162","type":"journal-article","created":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T06:41:40Z","timestamp":1755326500000},"page":"2317-2327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bilateral versus\u00a0Unilateral Training With Rhythmic Auditory Cueing in Stroke Rehabilitation: Effects on Upper\u00a0Limb Function and Interhemispheric Inhibition"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6628-9183","authenticated-orcid":false,"given":"Fangfang","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou Guangdong China"},{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianliang","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Guangzhou Red Cross Hospital Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luying","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youhua","family":"He","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Medical Treatment Ward, Nanfang Hospital Southern Medical University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The First Affiliated Hospital of Jinan University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10020190"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000087172.16305.CD"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1432510"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200412000-00013"},{"issue":"9","key":"e_1_2_11_6_1","first-page":"1228","article-title":"Brain Plasticity After Stroke\u2014Implications for Post\u2010Stroke Rehabilitation","volume":"127","author":"Dietrichs E.","year":"2007","journal-title":"TIDSSKR Norske LAEGE"},{"key":"e_1_2_11_7_1","first-page":"79","volume-title":"Handbook of Neuropsychology","author":"Winstein C.","year":"2003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2005.04.001"},{"key":"e_1_2_11_9_1","first-page":"115","volume-title":"Handbook of Neurological Rehabilitation","author":"Cohen L. 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