What question did this study set out to answer?

To compare the effectiveness of comprehensive bilateral training versus conventional rehabilitation in motor recovery for hemiplegic patients post-stroke.

February 23, 2026Open Access

Effect of Comprehensive Bilateral Training Protocol on Motor recovery in post-Stroke Hemiplegia- A Randomized Controlled Trial

PHPallavi HarjpalDatta Meghe Institute of Medical Sciences MQMoh’d Irshad QureshiDatta Meghe Institute of Medical Sciences RKRakesh Krishna KovelaNitte University

Key Points

To compare the effectiveness of comprehensive bilateral training versus conventional rehabilitation in motor recovery for hemiplegic patients post-stroke.
Forty hemiplegic patients randomized into two groups: Group A (Conventional Physiotherapy) and Group B (Comprehensive Bilateral Training).
Each group underwent 5 days/week training for 6 weeks focusing on task-oriented approaches and strength training.
Assessments conducted using Fugl-Meyer Assessment of Lower Extremity and Brunnstrom Stage of Recovery pre- and post-intervention.
Both groups showed significant improvement (p < 0.05) in motor recovery measures.
Group B displayed a greater improvement in the mean total FMA score difference (8.45 ± 2.19) compared to Group A (7.15 ± 1.84).
Brunnstrom stage change was significantly higher in Group B (2.70 ± 0.68) compared to Group A (1.50 ± 0.65), with a significant between-group difference (p = 0.0001).

Abstract

AbstractBackground and Purpose Most physiotherapists focus on the affected (hemiparetic) side when developing a rehabilitation plan for a hemiplegic patient. The less-affected side is left inactive and begins to lose its qualities, which deconditions the patient's overall rehabilitation. The objective of the study was to compare between extensive bilateral training and traditional rehabilitation methods for motor recovery. Methods Forty hemiplegic patients were selected for this randomized controlled trial. Patients were randomly assigned to two groups: Group A (Conventional Physiotherapy) and Group B (Comprehensive Bilateral Training) using a 1:1 simple randomization scheme. Ethical clearance was obtained from the Institutional Ethics Committee of Datta Meghe Institute of Higher Education and Research (DMIHER, DU), Wardha (Ethical permission number: DMIHERDU/IEC/2024/310), and the study was registered with the Clinical Trials Registry of India (CTRI/2024/11/077143). Eligible participants with subacute stroke were randomly allocated to either Group A (Conventional Physiotherapy) or Group B (Comprehensive Bilateral Training), using the Sequentially Numbered Opaque Sealed Envelope (SNOSE) method. Enrolment in the study, intervention procedures, and outcome assessment followed Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) standards. Patients in Group A received task-oriented approach-oriented training for the affected side, and Group B received strength training for the lower limb using a protocol identical to that of Group A for the unaffected side, for 5 days/week for 6 weeks. A strengthening regimen was designed for the unaffected side, based on the FITT (frequency, intensity, time, type) principles of the American College of Sports Medicine (ACSM). The Fugl-Meyer Assessment of the Lower Extremity (FMA-LE) and the Brunnstrom Stage of Recovery were assessed at baseline and post-rehabilitation. Results Both groups showed significant improvement (p Conclusion The findings of this study reveal that, compared with the Affected Side Training Group, both side groups had favourable effects on the stroke-specific disability index in subacute hemiparetic stroke patients, aiding early recovery.

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