# Perceptual motor interaction to improve bimanual coordination after stroke

> **NIH NIH R01** · ALBERT EINSTEIN HEALTHCARE NETWORK · 2022 · $375,247

## Abstract

PROJECT SUMMARY:
Difficulty incorporating the weaker arm in everyday activities significantly contributes to impaired function and
quality of life after stroke. Most prevalent rehabilitation approaches that focus on improving the unimanual
performance of the weaker arm have had limited impact on weaker arm use and integration in the real world. In
contrast to the unimanual focus of rehabilitation approaches, most tasks of daily living engage both arms in a
highly coordinated and interactive manner. After unilateral stroke, the interactive coordination between the two
arms is significantly impaired, even in patients with mild unimanual deficits, and is seldom remediated by
unimanual training. Impaired bimanual coordination may greatly limit the integration of the weaker arm in daily
activities, most of which are bimanual. Therefore, targeted training of bimanual coordination is necessary to
achieve a more complete functional arm recovery. Designing effective training however requires a clear
characterization of the fundamental deficits in how stroke survivors coordinate their arms, and how task
demands influence that coordination. Further, to move in the direction of more definitive clinical investigations
of bimanual training, it is important to identify factors that help explain individual variability in bimanual
coordination after stroke. The proposed studies will determine: (a) how motor and perceptual task demands of
a bimanual reaching task interact to influence coordination between arms in stroke survivors compared to age-
matched controls, (b) the immediate effects of changing perceptual and motor task demands on bimanual
coordination in stroke survivors and (c) the behavioral, neuroanatomic and neurophysiologic contributors to
individual differences in bimanual coordination after stroke. The approach is strong in that it aims to determine
the fundamental nature of bimanual control deficit(s) after stroke and then tests specific strategies to target the
underlying deficit(s). Particularly innovative is the manipulation of perceptual task demands in a virtual
environment to influence coordination between hands. Also, multimodal investigation to identify the contribution
of lesion and neural connectivity to bimanual coordination in stroke survivors is novel. The proposed project is
significant because it will provide fundamental understanding of brain-behavior relationship for bimanual
coordination after stroke. This will advance the science of rehabilitation with a stronger clinical impact. For
instance, identifying which patients have impaired bimanual coordination and who show improvements with
perceptual cueing will provide crucial information for testing evidence-based targeted training of bimanual
coordination in future studies. The results from this project will set the stage for future investigations aimed at
the development of intervention protocols to improve bimanual coordination necessary for more complete
functional arm recovery...

## Key facts

- **NIH application ID:** 10153461
- **Project number:** 5R01HD092481-04
- **Recipient organization:** ALBERT EINSTEIN HEALTHCARE NETWORK
- **Principal Investigator:** Shailesh Kantak
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $375,247
- **Award type:** 5
- **Project period:** 2018-05-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10153461

## Citation

> US National Institutes of Health, RePORTER application 10153461, Perceptual motor interaction to improve bimanual coordination after stroke (5R01HD092481-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10153461. Licensed CC0.

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