EXPLORING THE BEST EXERCISE FOR WRIST MOTOR PRIMING: A SYSTEMATIC REVIEW ON BILATERAL ACTIVE-PASSIVE APPROACHES

Stroke and traumatic brain injury commonly lead to upper extremity motor impairment, particularly affecting wrist movement and cognitive motor control. Bilateral Active Passive Priming (BAPP) devices have been developed as neuroplasticity-based tools that promote motor recovery through synchronized bilateral movements and neural priming mechanisms. This systematic review examined the efficacy of BAPP-based bilateral priming in enhancing wrist mobility and cognitive motor performance among individuals with stroke or traumatic brain injury. Following PRISMA 2020 guidelines, comprehensive searches of MEDLINE/PubMed, the Cochrane Library, Scopus, and Web of Science identified randomized controlled trials involving adults with upper limb hemiparesis who received bilateral priming interventions. Primary outcomes included the Wolf Motor Function Test and the Action Research Arm Test, while the Fugl Meyer Upper Extremity Assessment served as a secondary measure. Seventeen studies encompassing 1,307 participants met inclusion criteria. Bilateral priming produced significant improvements in wrist motor performance and functional recovery, with effect sizes ranging from 0.48 to 1.14. Neurophysiological evidence demonstrated normalized interhemispheric inhibition and increased cortical excitability following intervention.