Comparison of the effects of bilateral and unilateral training after stroke: A meta-analysis

Yejin Lee, Moon Young Kim, Ji Hyuk Park, Hae Yean Park

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


BACKGROUND: The differential effects of bilateral and unilateral training on upper extremity (UE) function remain unclear. OBJECTIVE: To compare the effectiveness of bilateral and unilateral training on UE function and activities of daily living (ADL) after stroke. METHODS: Randomized controlled trials (RCTs) were selected for inclusion by two reviewers after searching the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and KoreaMed. Methodological qualities were assessed using the PEDro scale. Effect size was estimated by calculating the standardized mean difference (SMD). RESULTS: Eleven RCTs of sufficient quality were included in our meta-analysis. The effect size on UE capacity was statistically significant in favor of the Constraint-Induced Movement Therapy (CIMT) groups (SMD [fixed], g:-0.34; 95 CI:-0.59-0.08; p = 0.01; I2 = 0). No other SMDs were significant. CONCLUSION: The CIMT tasks were more effective than bilateral training with regard to increased UE capacity; however, this result should be cautiously interpreted since the evaluation tools were designed for assessment of unilateral UE function, not bilateral UE function. Further, the effect of the CIMT tasks on UE capacity was not translated into ADL. Considering the disadvantages of CIMT such as fatigue, bilateral training may be more appropriate for improving ADL.

Original languageEnglish
Pages (from-to)301-313
Number of pages13
Issue number3
Publication statusPublished - 2017

Bibliographical note

Funding Information:
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (grant number: 2015R1C1A1A01054159).

Publisher Copyright:
© 2017 - IOS Press and the authors. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


Dive into the research topics of 'Comparison of the effects of bilateral and unilateral training after stroke: A meta-analysis'. Together they form a unique fingerprint.

Cite this