{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:51:33Z","timestamp":1790711493603,"version":"4.1.0"},"reference-count":45,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Integrating high dosage bilateral movements to improve upper limb (UL) recovery after stroke is a rehabilitation strategy that could potentially improve bimanual activities.\n\nObjectives: This study aims to compare the effects of bilateral with unilateral UL training on upper limb impairments and functional independence in (sub)acute stroke.\n\nMethod: Five electronic databases (PubMed, Scopus, PEDro, ScienceDirect, Web of Science) were systematically searched from inception to June 2023. Randomised controlled trials comparing the effect of bilateral training to unilateral training in stroke survivors (&lt; 6 months poststroke) were included. The treatment effect was computed by the standard mean differences (SMDs).\n\nResults: The review included 14 studies involving 706 participants. Bilateral training yielded a significant improvement on UL impairments measured by FMA-UE compared to unilateral training (SMD = 0.48; 95% CI: 0.08 to 0.88; P = 0.02). In addition, subgroup analysis based on the severity of UL impairments reported significant results in favour of bilateral UL training in improving UL impairments compared to unilateral training in \u201cno motor capacity\u201d patients (SMD = 0.66; 95% CI: 0.16 to 1.15; P = 0.009). Furthermore, a significant difference was observed in favour of bilateral UL training compared to unilateral UL training on daily activities measured by Functional Independence Measure (SMD = 0.45; 0.13 to 0.78; P = 0.006).\n\nConclusion: Bilateral UL training was superior to unilateral training in improving impairments measured by FMA-UE and functional independence in daily activities measured by Functional Independence Measure in (sub)acute stroke.\n\nClinical implications: Bilateral upper limb training promotes recovery of impairments and daily activities in (sub)acute phase of stroke.<\/jats:p>","DOI":"10.4102\/sajp.v80i1.1985","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T04:56:50Z","timestamp":1706072210000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Bilateral versus unilateral upper limb training in (sub)acute stroke: A systematic and meta-analysis"],"prefix":"10.4102","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9292-2920","authenticated-orcid":false,"given":"Justine","family":"Dembele","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nbhqj75","id-type":"ROR","asserted-by":"publisher"}],"name":"Hasselt University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9097-9352","authenticated-orcid":false,"given":"Lisa","family":"Tedesco Triccas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nbhqj75","id-type":"ROR","asserted-by":"publisher"}],"name":"Hasselt University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1315-8774","authenticated-orcid":false,"given":"Elogni Renaud","family":"Amanzonw\u00e9","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nbhqj75","id-type":"ROR","asserted-by":"publisher"}],"name":"Hasselt University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9117-7191","authenticated-orcid":false,"given":"Oy\u00e9n\u00e9","family":"Kossi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nbhqj75","id-type":"ROR","asserted-by":"publisher"}],"name":"Hasselt University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9444-1349","authenticated-orcid":false,"given":"Annemie","family":"Spooren","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04nbhqj75","id-type":"ROR","asserted-by":"publisher"}],"name":"Hasselt University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Adoukonou, T., Kossi, O., Fotso Mefo, P., Agb\u00e9tou, M., Magne, J., Gbaguidi, G. et al., 2021, \u2018Stroke case fatality in sub-Saharan Africa: Systematic review and meta-analysis\u2019, International Journal of Stroke: Official Journal of the International Stroke Society 16(8), 902\u2013916. https:\/\/doi.org\/10.1177\/1747493021990945","DOI":"10.1177\/1747493021990945"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Agbetou Houessou, M., Hountada, H., Yahou\u00e9d\u00e9ou, B., Choki, B., Kossi, O. & Adoukonou, T., 2021, \u2018Knowledge of stroke risk factors and signs in Parakou, a Northern City of Benin in West Africa\u2019, Cerebrovascular Diseases (Basel, Switzerland) 50(1), 88\u201393. https:\/\/doi.org\/10.1159\/000512715","DOI":"10.1159\/000512715"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Amanzonw\u00e9, E.R., Tedesco Triccas, L., Codjo, L., Hansen, D., Feys, P. & Kossi, O., 2023, \u2018Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke\u2019, The South African Journal of Physiotherapy 79(1), 1846. https:\/\/doi.org\/10.4102\/sajp.v79i1.1846","DOI":"10.4102\/sajp.v79i1.1846"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Arya, K.N. & Pandian, S., 2014, \u2018Interlimb neural coupling: Implications for poststroke hemiparesis\u2019, Annals of Physical and Rehabilitation Medicine 57(9\u201310), 696\u2013713. https:\/\/doi.org\/10.1016\/j.rehab.2014.06.003","DOI":"10.1016\/j.rehab.2014.06.003"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Brunner, I.C., Skouen, J.S. & Strand, L.I., 2012, \u2018Is modified constraint-induced movement therapy more effective than bimanual training in improving arm motor function in the subacute phase post stroke? 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