Bilateral Arm Training (BAT) comprises repetitive practice of bilateral arm movements in symmetrical or alternating patterns. Traditionally, bilateral arm training was performed by linking both hands together so that the less-affected limb facilitated passive movement of the affected limb. Variations of bilateral arm training include bilateral isokinematic training (spatiotemporally identical active movements performed during functional tasks), use of mechanical devices to drive passive or active movement of the affected limb, or bilateral arm training with rhythmic auditory cueing or electromyography (EMG) stimulation.
The use of bilateral arm training in stroke rehabilitation is based on the assumption that symmetrical bilateral movements activate similar neural networks in both hemispheres, promoting neural plasticity and cortical repair that result in improved motor control in the affected limb. Bilateral arm training is suitable for use as an adjunct to other upper limb interventions and should involve repetitive movement during performance of novel, functional tasks.
Authors*: Annabel McDermott (OT), Dr Nicol Korner-Bitensky (PhD OT), Dr Tatiana Ogourtsova (PhD OT)
Evidence reviewed as of before 11-06-2018