Effectiveness of Bilateral Arm Training With and Without Rhythmic Auditory Cueing on Functional Mobility of the Upper Limb in Stroke Survivors.

BACKGROUND: Stroke commonly results in upper limb motor impairment, leading to reduced functional independence and quality of life. Bilateral arm training (BAT) and bilateral arm training with rhythmic auditory cueing (BATRAC) are rehabilitation approaches used to improve upper limb function following stroke. However, the additional benefit of incorporating RAC into BAT requires further investigation. OBJECTIVE: To compare the effects of BAT with and without RAC on functional mobility of the upper limb in stroke survivors. METHODS: This experimental study enrolled 24 stroke survivors (age 30-50 years; Brunnstrom stage ≥3; Fugl-Meyer Assessment [FMA] arm score 23-47; stroke duration three or more months) using consecutive sampling. Participants were allocated to Group A (BAT alone, n=12) or Group B (BAT with RAC, n=12). Both groups received 35-minute structured bilateral upper limb training sessions five days per week for four weeks, with Group B performing tasks synchronized to a progressive metronome tempo (60-80 bpm). Outcome measures included the FMA upper extremity score and the Action Research Arm Test (ARAT), assessed at baseline and post-intervention. Paired t-tests were used for within-group comparisons and unpaired t-tests for between-group comparisons. Statistical significance was set at p<0.05. RESULTS: Both groups demonstrated statistically significant improvements following the intervention. Group A showed a mean FMA improvement of 6.75 (p=0.0426) and a mean ARAT improvement of 8.67 (p=0.0031). Group B demonstrated greater improvements, with a mean FMA gain of 9.67 (p=0.002) and a mean ARAT gain of 14.59 (p<0.0001). Between-group analysis showed significantly greater improvements in Group B for both FMA (mean difference 2.917; t=3.211; p=0.0040) and ARAT (mean difference 5.917; t=4.410; p=0.0002). CONCLUSION: Both BAT alone and BAT combined with RAC significantly improved upper limb motor function in stroke survivors. However, the addition of RAC resulted in significantly greater improvements in both motor impairment and functional performance. These findings support the incorporation of BATRAC as an accessible rehabilitation strategy for enhancing upper limb recovery after stroke.