ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Neurology
Robotic Bimanual Arm Training Improves Upper Limb Function in Children with Hemiparesis: A Feasibilty Study
Provisionally accepted
Talita Campos1
Shivakeshavan Ratnadurai Giridharan2,3Marion-Victoria Wairimu2
Annie Li2Sara Tamayo4
Kathleen Friel2,3*- 1Columbia University Irving Medical Center, Columbia University, New York, New York, United States
- 2Burke Neurological Institute (BNI), White Plains, New York, United States
- 3Weill Cornell Medicine, Cornell University, New York, New York, United States
- 4Mercy College, Dobbs Ferry, New York, United States
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Abstract Introduction: In children with hemiparesis, bimanual training can produce greater gains in upper limb function compared with unimanual training of the impaired upper limb. Moreover, repetitive skilled practice is a critical component of effective interventions. The objective of this study was to determine whether upper limb training using a bimanual-to unimanual robotic training device is feasible and effective for improving hand function in children with hemiplegia. We hypothesized that this robotic training would improve motor outcomes on the Assisting Hand Assessment (AHA), the Box and Blocks Test (BBT), and the Jebsen-Taylor Test of Hand Function (JTTHF). Methods: Children (n=8, 6 males, 2 females, age 5-17 years) with hemiparesis participated in a feasibility study using a robotic device called the Bimanual Arm Trainer (BAT, Mirrored Motion Works). This device encourages mirrored bimanual movements and uses an engaging gaming interface to encourage repetitive movements. The BAT provides bimanual-to-unimanual training of yoked shoulder external rotation and elbow extension, as well as training of pronation, supination and grasp and release of each hand independently. Results: Although the study was halted by the COVID-19 pandemic, eight children completed 18 training sessions on the BAT (2x/week for 9 weeks). While range of motion did not change significantly, children significantly improved in bimanual (AHA) and unimanual (BBT) function. Discussion: Children enjoyed the device, and provided feedback that was used to improve the gaming environment. Further work is needed to determine ideal dosing to optimize improvements.
Keywords: Cerebral Palsy, acquired brain injury, Hemiplegia, Upper Extremity, Pediatrics, Rehabilitation
Received: 27 Sep 2024; Accepted: 30 Oct 2025.
Copyright: © 2025 Campos, Ratnadurai Giridharan, Wairimu, Li, Tamayo and Friel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kathleen Friel, kathleen.friel.phd@gmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.