What question did this study set out to answer?

The research aims to summarize existing literature on bimanual therapy for post-stroke rehabilitation, focusing on approaches and outcomes.

February 2, 2026

Abstract TP349: Bimanual Therapy for Post Stroke Individuals: A Scoping Review of Evidence, Protocols, and Outcomes

Key Points

The research aims to summarize existing literature on bimanual therapy for post-stroke rehabilitation, focusing on approaches and outcomes.
Conducted a scoping review based on PRISMA ScR guidelines.
Reviewed literature in PubMed/MEDLINE, CENTRAL, and trial registries.
Included studies involving adults with post-stroke upper limb impairments receiving structured bilateral training.
Analyzed various outcomes such as motor function, ADLs, and safety.
Bilateral training significantly improves motor impairment, with average gains of 4-8 points on FMA UE compared to conventional therapy.
Notable benefits of bilateral training are observed in chronic, mildly impaired patients, especially at higher doses.
Bilateral training approaches include functional tasks, auditory cueing, and robotic devices, enhancing motor function and cortical reorganization.
Common outcomes reported include motor impairment measures, activity scales, quality of life metrics, and neuroplasticity indicators.
Key gaps identified include the need for standardized protocols and limited long-term data on outcomes.

Abstract

Background/Rationale: Bimanual therapy (BT), engaging both hands simultaneously in functional or task specific activities, is increasingly used to target post stroke upper limb deficits. Evidence, however, is scattered across heterogeneous protocols, patient populations, and outcome metrics, making clinical translation challenging. Objective: To map adult post stroke bilateral training literature, summarizing approaches, populations, outcomes, effects (efficacy, feasibility, safety), and gaps to inform practice and research. Methods: Scoping review (PRISMA ScR) of PubMed/MEDLINE, CENTRAL, trial registries; backward snowballing from recent meta analyses. Included adults with post ischemic/hemorrhagic stroke upper limb impairment receiving structured bilateral training (e.g., bilateral arm training, bimanual functional tasks, mirror based bimanual paradigms, robotic assisted bimanual rehab). Outcomes: motor function, ADLs, neuroplasticity, QoL, adherence, and safety. Results: Meta analyses of 14-25 RCTs (~700-840 patients) show that bilateral training (BT) improves motor impairment (FMA UE +4-8 points) more than conventional therapy, especially in chronic, mildly impaired, and high dose settings. Benefits over unilateral training are modest overall, but significant in subacute stroke for motor and ADL outcomes. BT approaches include bilateral functional tasks, rhythmic auditory cueing (BATRAC), robotic devices (e.g., Bi Manu Track, exoskeletons), and mirror-based paradigms. Trials show BT can enhance motor outcomes, distal hand function, and even cortical reorganization, with high repetition protocols (2–6 weeks, several sessions/week) and minimal adverse events. Common outcomes are motor impairment (FMA UE, ARAT, WMFT), activity/ADL scales, QoL measures, and neuroplasticity markers. Motor impairment improves most consistently; functional and QoL results are mixed. Key gaps: heterogeneous protocols/dosing, small samples, limited long-term data, sparse reporting of QoL, adherence, and safety, and few stratified or pragmatic head to head trials. Conclusions: BT is a feasible and generally safe post stroke strategy with consistent motor impairment benefits and selective functional advantages, particularly with BFTT, appropriate dosing, and phase/severity informed selection. Priority areas include standardized protocols and dosing, pragmatic trials powered for ADL/QoL, and integration of neurophysiological markers to refine for whom/what dose/which protocol decisions.

Abstract TP349: Bimanual Therapy for Post Stroke Individuals: A Scoping Review of Evidence, Protocols, and Outcomes

Key Points

Abstract

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