Saturday, May 19, 2012

Tailwind (BATRAC) Research Studies

We would like you to know that there are a number of research studies that have investigated the effectiveness of the BATRAC (Bilateral Arm Training with Rhythmic Auditory Cueing) method of exercising arm function.  You will find some details below.  Now you know why we call the product implementing this exercise method - TailWind.   Tailwind takes the principles of BATRAC and implements them in a consumer friendly, well engineered product that you can take home and use.

1.  Whitall, J., McCombe Waller, S., Silver, K.C. & Macko, R.F. (2000) Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke.  Stroke 31, 2390-2395.

This study demonstrated the feasibility of BATRAC with a one group design in individuals with chronic stroke.  After 18 sessions (about 6-8 weeks) of preferred speed exercise on BATRAC (4 x 5mins) there was a significant increase in the scores of Fugl Meyer (FM), Wolf time and the University of Maryland Arm Questionnaire for Stroke.  The increase was maintained after 9 weeks of no exercise.


2.  McCombe Waller, S, & Whitall, J. (2004) Fine motor function in adults with chronic hemiparesis: Baseline comparison to non-disabled adults and effects of bilateral arm training.  Archives of Rehabilitation and Physical Medicine 85, 1076-83.

This study demonstrated that individuals with chronic stroke had disruption of non-paretic finger consistency in bilateral tapping which was improved after 6 weeks of basic BATRAC.  Thus despite the apparent lack of training specificity there were some generalizable effects from BATRAC to fine-motor interlimb coordination.  In addition for the four subjects who could manage unilateral paretic finger tapping, two improved their unilateral paretic performance post training while 2 had equivocal results.


3.  Luft AR, McCombe Waller S, Whitall J, Forrester LW, Macko RF, Sorkin JD, Schulz MD Goldberg AP, Hanley D (2004) Repetitive bilateral arm training and motor cortex activation in chronic stroke Journal of American Medical Association. 292,1853-61.

This study was a small randomized control trial using fMRI to document re-organization in central motor networks.  Six of 9 individuals who had BATRAC training demonstrated re-organization in contralesional motor networks.  This re-organization was not demonstrated in those who undertook a dose-matched therapeutic exercise (DMTE) control therapy.  In addition, when the non-responders after BATRAC were eliminated from analysis, the BATRAC group showed a differential increase in FM scores.


4.  McCombe Waller, S, & Whitall, J. (2005)  Hand Dominance and Side of Stroke Affect Rehabilitation in Chronic Stroke.  Clinical Rehabilitation, 19, 544-51.

This study compared the effect of 6 weeks basic BATRAC across those whose lesion was in their motor dominant (left) vs. motor non-dominant (right) hemisphere.  There were no baseline differences between the groups but a clear training response advantage in those with left hemisphere lesions who responded positively to more outcome measures.


5.  Whitall, J., McCombe Waller, S., Luft, A., Hanley, D.  (2006).  Motor function improvement is associated with brain re-organization after bilateral arm training in chronic stroke – Case report.  Physioscience, 2, 93-98.
In this case report, one subject demonstrated motor function gains as well as new contralesional activation after 6 weeks of BATRAC.


6.  McCombe Waller, S., Liu, W., and Whitall, J., (accepted) Temporal and Spatial Control following Bilateral versus Unilateral Training,  Human Movement Science.

In this small randomized controlled study we demonstrated improvements in both spatial and temporal control of the arms during bilateral reaching tasks after 6 weeks of BATRAC training compared to 6 weeks of unilateral arm training. This study emphasized the importance of examining bilateral arm motor function after bilateral arm training and the inclusion of measures of temporal and spatial control.


7.  Whitall, J., McCombe Waller, S., Sorkin, J., The Baltimore Pepper team, Goldberg, A.  (in preparation)   Differential benefits of bilateral and unilateral arm training in chronic stroke:  A single-blinded randomized controlled trial.