Table 2 Summary of the articles selected for review (sorted by the target condition and first author’s last name)

Brachial plexus injury

Duff et. al.; 2007 [172]

Patients with a BPI (16; 7.8 years); No healthy control

Examine the glenohumeral and scapulothoracic joint contributions to arm elevation to better understand the interlimb differences in children with unilateral BPI

The involved limb displayed lower glenohumeral joint excursion than the non-involved limb. The scapulothoracic joint made a greater contribution to arm elevation than the glenohumeral joint only in the involved limb

Level IV

Nazarahari et. al.; 2021 [173]

Patients with a BPI (15; 54 ± 16 years); Healthy control (15; 24 ± 3 years)

Assess the alterations of shoulder motion pattern and trick trunk movements caused by BPI in terms of their impact on shoulder function asymmetry

AI from several kinematic scores of the upper arm and trunk showed a significant difference (P < .05) between the affected and control groups

Level III

Webber et. al.; 2019 [174]

Patients with a BPI pre-surgery (10; 34 ± 12 years), post-surgery (10; 35 ± 12 years); Healthy control (10; 38 ± 12 years)

Develop a method to report bilateral UE activity in patients with BPI who have undergone surgery to restore arm function

Compared to controls, the pre-surgery group (p < 0.0001, p < 0.0001) and post-surgery group with pan-plexus injuries (p = 0.0074, p = 0.0242) both exhibited statistically significant differences in forearm and upper arm asymmetry, respectively

Level II

Cerebral palsy

Beani et. al.; 2019 [175]

Unilateral CP (50; 9.93 ± 5.23 years); Healthy control (50; 10.14 ± 5.19 years) children

Assess the feasibility of comprehensive indices derived using 3D accelerometers to gauge the use of UE between treatment and control groups while drawing comparisons with currently used outcome measures

AI (p < 0.001) was related to MACS levels and was different between the treatment and control groups (p < 0.001). Quantitative data better described UE activity and asymmetry

Level III

Dellatolas et. al.; 2005 [176]

Children with CP (30; 7.52 ± 0.33 years); Two groups of healthy control (30; 7.47 ± 0.26 years & 30; 7.52 ± 0.16 years)

Verify whether PMTs are useful for assessment of hand skills; Relate PMT to ADL

PMT times correlated well with ADL. Unimanual ADL are associated with the less affected hand and bimanual with the more affected hand

Level III

Friel et. al.; 2014 [177]

Children with unilateral CP (35; 7.9 ± 2.9 years); No healthy control

Examine the association between an estimate of CST dysgenesis, hand function, and bimanual training in children with CP

Bimanual training improved hand function (p < 0.001). Estimated CST dysgenesis correlated with hand function but not with its post-training improvement

Level II

Gaillard et. al.; 2018 [178]

Children with CP (23; 11.83 ± 2.67 years); Healthy control (23; 11.92 ± 2.42 years)

Evaluate the relationship between the movement abnormalities of the impaired upper limb in children with unilateral CP and bimanual performance

Values of kinematic indices were significantly higher in children with unilateral CP than in typically developing children

Level III

Gordon et. al.; 2007 [179]

Children with hemiplegic CP (10; 8.43 ± 3.67 years); Healthy control (10; 6.76 ± 2.33 years)

Examine the efficacy of HABIT in improving bimanual coordination in children with CP

Children in the intervention group showed improved bimanual coordination (p < 0.05)

Level I

Hoyt et. al.; 2020 [180]

Children with CP (26; 8.5 years); Healthy control (26; 8.4 years)

Use accelerometry to measure motor behavior. Compare accelerometry to clinical assessment

Hemiparesis is associated with a lower use ratio than controls (p < 0.001). Children with hemiparesis depended largely on their dominant UE for independent movements

Level III

Huang et. al.; 2014 [181]

Children with CP (9; 4 years); Healthy control (9; 3.92 years)

Examine body-scaled information that specifies the reach patterns of children with hemiplegic cerebral palsy and children with typical development

The critical ratio was not significantly different for either preferred or nonpreferred arms within and between groups. All children used an exclusive 2-handed reach at a similar dimensionless ratio

Level IV

Hung et. al.; 2004 [18]

Teenagers with CP (10; 13.42 ± 3.5 years); Healthy control (10; 13.08 ± 2.92 years)

Examine bimanual coordination using a drawer-opening task under speed and hand constraints

The children with hemiplegic CP were slower (p < 0.001) and less coordinated in this task, with reduced movement overlap of the two hands (p < 0.001) and sequential completion of the two movement objectives (p < 0.001). The hand used for each task affected task performance (p < 0.05)

Level IV

Hung et. al.; 2020 [182]

Children with Unilateral CP (10; 9.5 ± 1.75 years) with healthy children (10; 9.67 ± 2.25 years); Healthy adults (10; 26.5 ± 7.08 years) as control

Examined how children with USCP perform a functional symmetric bimanual tray lifting task

Children with USCP exhibited greater bilateral asymmetry in hand vertical position, timing, upper arm, and elbow control than other groups (p < 0.05)

Level II

Kara et. al.; 2020 [183]

Children with CP (15; 12.4 ± 2.8 years); Healthy control (16; 12.3 ± 2.07 years)

Investigate performance (touch-coordinate errors, inter-touch interval) of touch screen technology in adolescents with unilateral CP and healthy peers

When comparing the dominant and non-dominant hand in the CP group, there was a significant difference on touch coordinate error with no visual feedback (p = 0.01)

Level III

Klevberg et. al.; 2018 [184]

Children with CP (102; 2.38 years); No healthy control

Investigate development of bimanual performance among young children with unilateral or bilateral CP

Children with symmetric hand use performed better than those with asymmetric hand use (p = 0.003)

Level II

Langan et. al.; 2010 [185]

Patients with CP (11; 33 ± 10 years); Healthy control (10; 32 ± 9 years)

Examine movement time and kinematic properties of unilateral and bilateral reaching movements in adults with CP

Bilateral simultaneous reaching movements were temporally and spatially coupled. Movement of the less affected arm slowed to match the movement of the more affected arm

Level III

McCall et. al.; 2022 [186]

Children with hemiplegic CP (4; 11.25 ± 1.5 years); Healthy control (10; 11.8 ± 1.6 years)

Assess and compare finger force and movement individuation in children with hemiplegic CP

Individuated force and movement were substantially reduced in the

paretic versus non paretic hands of children with hemiplegic CP (p < 0.001)

Level IV

Mutalib et. al.; 2019 [187]

Children with CP (15; 8.7 ± 2.7 years); Healthy children as control (17; 8.2 ± 2.5 years)

Examine temporal, force, and kinematic coordination between the two hands in USCP affected and typically developing children, during a physically coupled lifting task

USCP subjects displayed compensating strategies for inter-limb asymmetries, such as muscle strength

Level III

Ricken et. al.; 2005 [188]

Children with spastic hemiparetic CP (10; 8.6 ± 1.8 years); No healthy control

Examine coordination of reaching with the impaired and non-impaired arm in children with spastic hemiparetic CP

Coordination patterns between elbow, shoulder, and trunk displayed less similarity when reaching with the impaired arm compared to the non-impaired arm

Level IV

Shum et. al.; 2020 [189]

Children with CP (5; 17 ± 3 years); Healthy children (12; 17 ± 3 years)

Explore the viability of an immersive VR environment that manipulated visual feedback (i.e., EA) during bimanual movements that could be implemented in engaging home-based rehabilitative systems

EA improved symmetry in the control and treatment groups

Level IV

Smits-Engelsman et. al.; 2005 [190]

Children with CP (20; 9.58 ± 3.33 years); 20 age-matched healthy control (no demographics data)

Measure the capacity of one group of spastic muscles (the finger flexors) to exert force and to grade force

Results showed that force generated with the affected hand was only one-third of that generated by the non-affected hand (p < 0.001) with slower time to peak (p < 0.001)

Level III

Steenbergen et. al.; 2000 [191]

Patients with Spastic Hemiparesis (CP) (6; 17.3 ± 1.6 years); No healthy control

Examine the limb dynamics of both limbs of spastic hemiparetic subjects under various task constraints

Peak velocity was not different with respect to the hand used. The time to reach peak velocity was different under unimanual and bimanual responding (p < 0.01). The analysis of mean velocity showed a higher mean velocity of the unimpaired hand as compared to the impaired hand (p < 0.05)

Level IV

Steenbergen et. al.; 2004 [192]

Teenagers with CP (6; 17.25 ± 1.25 years); No healthy control

Investigate ipsi- and contra-lesional control of prehension after unilateral brain damage

Kinematic variables of the transport and grasp component were remarkably similar between both sides of the body

Level IV

Steenbergen et. al.; 2008 [193]

Children with hemiplegic CP (7; 8.97 ± 3.14 years); No healthy control

Examine unimanual and bimanual fingertip force control during grasping in children with hemiplegic CP

The less-affected hand slowed down when moving together with the affected hand. Grip force at onset of load force, and peak grip force improved marginally for the affected hand during bimanual tasks

Level IV

Tomhave et. al.; 2014 [194]

Children with CP (37; 9.8 years); No healthy control

Determine how the affected hemiplegic hand and contralateral dominant hand in children with hemiplegic cerebral palsy compare with age-matched norms for grip strength, pinch strength, and dexterity

Affected hands had significantly less grip and pinch strength than the contralateral hands (p < 0.001). Dexterity in both affected and contralateral hands was significantly less than normative values (p < 0.01)

Level II

van Roon et. al.; 2000 [195]

Teenagers with CP (11; 17.1 ± 1.2 years); No healthy control

Locate the source of slowness in typing movements in subjects with spastic hemiparesis and to examine whether enlargement of keys would facilitate typing

The impaired hand tapped slower and more irregularly and exerted less force (p < 0.05). Enlargement of the keys shortened flight time (i.e. time in which the finger moves through the air from one key to the next) of the impaired hand, but not dwell time (p < 0.01)

Level IV

van Thiel et. al.; 2000 [196]

Teenagers with hemiparetic CP (12; 17.37 ± 1.3 years); Healthy control (12; 23 years)

Examine the control that hemiparetic subjects have over fast, unimanual aiming movements

Mean movement velocity was lower for the CP subjects than for the control subjects (p < 0.05). Path variability was larger for the CP group (p < 0.05)

Level III

van Thiel et. al.; 2001 [197]

Children with CP (8; 18 ± 1.5 years); No healthy control

Examine the degree and timing of shoulder displacements during hitting, reaching, and grasping movements performed by young adults with hemiparetic cerebral palsy

The hand used was significant for reaching and grasping tasks (p < 0.05). the impaired hand was less fluent compared to the unimpaired hand (p < 0.05)

Level IV

Verrel et. al.; 2008 [198]

Patients with CP (6; 20 to 25 years); Healthy control (10; 14 to 19 years)

Investigated eye–hand coordination in adolescents with hemiparetic CP and neurologically healthy controls

Increase in visual monitoring of participants with CP when using their affected hand at the beginning as well as during object transport

Level IV

Volman et. al.; 2005 [199]

Children with hemiplegic CP (10; 10.6 ± 1.2 years); No healthy control

Investigate the effect of amplitude incongruence and form incongruence on the performance of the affected and non-affected arm

Aspects of movement execution, but not aspects of movement planning are affected by the “hemiplegic” condition in children with hemiplegic CP

Level IV

Xu et. al.; 2015 [200]

Children with CP (68; 4.58 ± 2.75 years); No healthy control

Investigate the characteristics of motor unit recruitment and coordination function of the wrist during maximum isometric voluntary contraction in children with hemiplegic CP

The activation in the affected hand were higher than that of the unaffected hand (P < .001). The co-contraction ratio of the unaffected hand was significantly lower than that of the affected hand (P < .001)

Level II

Multiple sclerosis

Pau et. al.; 2021 [201]

Patients with MS (28; 50.6 ± 9.3 years); Healthy control (28; 48.7 ± 9.5 years)

Characterize the major features of upper limb usage in patients with MS with respect to unaffected individuals, in terms of overall activity time, intensity, and inter-limb symmetry in uni- and bilateral activities

The MS group were characterized by significantly lower overall activity, they used their dominant limb for a significantly longer time and, while performing bilateral activities, their dominant limb expressed movements of superior intensity in a proportion higher than what was observed in unaffected individuals

Level III

Severijns et. al.; 2016 [202]

Patients with MS (19; 56 ± 12 years); Healthy control (19; 56 ± 13 years)

Determine the difference in hand grip fatigability between healthy persons and people with MS for both hands during low-intensity hand grip exercises

There was a significant decrease in maximal hand grip strength after exercising in both groups and for both hands (p < 0.01)

Level III

Solaro et. al.; 2020 [203]

Patients with MS (549; 45 ± 13.14 years); No healthy control

Determine whether a non-linear association between NHPT performance and EDSS, conditional on the level of asymmetry between the two hands exists

It was demonstrated that by including information about asymmetry in the model, an average positive change in accuracy of 0.16 EDSS points (SD = 0.49) was obtained in the overall sample (n = 549); additionally, an average change in accuracy was highest among patients with EDSS > 6, followed by patients with EDSS ≤ 3, while average change is negligible in patients with EDSS in the 3.5 – 6 range

Level IV

Unluer et. al.; 2019 [204]

Patients with MS (20; 39.95 ± 12.22 years); Healthy control (20; 35.99 ± 11.96 years)

Investigate upper extremity function and shoulder position sense in patients with MS

Upper extremity function scores were lower and shoulder position sense error scores were greater in patients with multiple sclerosis in comparison to healthy controls (p < .05)

Level III

Parkinson’s disease

Di Caprio et al.; 2020 [205]

Patients with right-dominant PD (17; 57.6 ± 6.8 years), left-dominant PD (17; 61.6 ± 5.6 years); Healthy control (24; 58.5 ± 6.9 years)

Assess whether PD patients show global or selective impairment in inhibition and compare right dominant patients with left dominant patients

Reactive inhibition was more impaired in PD patients (p < 0.05). Proactive inhibition was not different. No difference between right and left dominant PD patients

Level III

Amano et. al.; 2015 [206]

Patients with PD (14; 64 ± 13 years); Healthy control (4; 56 ± 11 years)

Assess the effects of dedifferentiation in the PD population using a reaching task

The dominant arm became slow and less flexible making its movement dynamics similar (p < 0.05) to the non-dominant arm

Level IV

Gorniak et. al.; 2013 [207]

Patients with PD and DBS implant (10; 61 ± 8 years); No healthy control

Investigate the effects of subthalamic DBS on time and force characteristics of simulated ADL

The data indicated that DBS parameter state did not affect most aspects of fine motor control in ADL-like tasks; however, features such as increased grip force and grip symmetry varied with the stimulation state. In the absence of DBS parameters, patients exhibited significant grip force asymmetry

Level II

Ham et. al.; 2015 [208]

Patients with PD affecting their dominant-side (57) and non-dominant-side (61) (64.7 ± 7.7 years); No healthy control

Compare dominant-side onset and non-dominant-side onset PD to evaluate whether dominant-side onset PD has greater neural reserve and fewer motor deficits despite similar pathological changes

Dominant-side subjects had fewer motor deficits than non-dominant-side subjects (p < 0.01). Hence, non-dominant-side PD causes higher UE asymmetry

Level III

Jackson et. al.; 2000 [209]

Patients with PD (14; 64.17 ± 5.76 years); Healthy control (4; 66 years)

Examine the proposal that the basal ganglia may serve to scale the amplitude of limb movements, with basal-ganglia dysfunction leading to the inappropriate scaling of intended motor activity (opening of hand)

Patients opened their hands wider for unimanual tasks compared to bimanual tasks (p < 0.05) with their non-preferred hand opening les wide (p < 0.05)

Level IV

Louie et. al.; 2009 [210]

Patients with PD (85; 60.9 ± 11.1 years); Healthy control (21; 57.9 ± 8.3 years)

Examine whether quantitative measures of movement velocity showed a relationship between bradykinesia and disease severity and whether this relationship was the same on the more affected and less affected sides

The velocities of finger and arm movements on both sides were inversely correlated with disease severity (p < 0.03). The performance of the less affected side was not different from that of controls (p > 0.05), whereas that of the more affected side was slower (p = 0.019)

Level II

Schaefer et. al.; 2021 [211]

Patients with PD (22; 63.58 ± 10.26 years); Healthy control (25; 68.48 ± 6.81 years)

Investigate whether mechanical muscular oscillations differ between PD patients and controls

Significant differences appeared for the power–frequency-ratio (p = 0.001). PD patients showed altered mechanical muscular output compared to controls

Level III

Stegemoller et. al.; 2016 [212]

Patients with PD (41; 68 ± 11 years); No healthy control

Compare repetitive finger movement performance between the more and less affected side, and the difference in clinical ratings among performance groups

There were no significant differences between the more and less affected sides

Level II

Yang et. al.; 2020 [213]

Patients with PD (16; 62.8 ± 6.83 years); Healthy control (25; 59.13 ± 6.38 years)

Investigate EMG characteristics of the UE between PD patients and healthy control subjects

There was a significant difference in the duration of activation and recurrence rate between the sides in the PD group (p < 0.05)

Level III

Peripheral nerve injury

Philip et. al.; 2021 [214]

Patients with a PNI affecting the dominant side (22; 42.23 ± 15.53 years) & non-dominant side (26; 46.27 ± 15.63 years); No healthy control

Identify how individuals respond to unilateral UE PNI via compensation (increased use of the nondominant hand)

Hand usage (dominant/nondominant) in the treatment group did not differ from typical adults, regardless of injured side (p > .07). Compensation was associated only with dominant hand dexterity (p < 0.001), not on nondominant hand dexterity, rehabilitation, or other patient and/or injury factors (p > 0.1)

Level II

Spinal cord injury

Bondi et. al.; 2022 [215]

Patients with a SCI (73; 49.9 ± 19.9 years); No healthy control

Determine whether cerebral dominance influences upper extremity recovery following cervical SCI

There were no significant differences (p < 0.05) for observed and relative recovery, between the dominant and non-dominant upper extremities

Level II

Britten et. al.; 2017 [216]

Patients with a SCI (20; 48.1 ± 15.9 years); Young healthy control (16; 23.68 ± 4.54 years) and old healthy control (16; 70.92 ± 7.2 years)

Investigate unimanual and bimanual coordination in patients with acute SCI using 3D kinematic analysis as they performed naturalistic reach to grasp actions with one hand, or with both hands together

Participants with a SCI produced reach-to-grasp actions which took longer, were slower, and had longer deceleration phases than uninjured participants

Level II

Calabro et. al.; 2016 [217]

Patients with SCI (16; 54.3 ± 12.8 years); Healthy control (20; 48.4 ± 18.1 years)

Study the effect of abnormalities in movement kinematics and EMG during bilateral reach-to-grasp movements

The more impaired arm affects the less impaired arm, negatively, in humans with asymmetric functional impairments in the arms due to incomplete cervical SCI

Level III

Lei et. al.; 2018 [218]

Patients with a SCI (20; 48.1 ± 15.9 years); Healthy control (20; 42.7 ± 10.7 years)

Study the different phases of unilateral self-paced reach-to-grasp movements in the more and less affected arms of individuals with cervical SCI and in age-matched controls

Deficits in movement kinematics during reach-to-grasp movements are more pronounced at the time to close the hand in the more affected arm of SCI participants

Level III

Schizophrenia

Lisi et. al.; 2018 [219]

Patients with SCZ (14; 30.78 ± 6.26 years); Healthy control (14; 30.9 ± 15.5 years)

Characterize asymmetries in movement initiation in SCZ by exploring single actions

SCZ patients, besides being overall slower than controls, additionally presented with a bias affecting both the moving hand and the side from which movements were initiated

Level III

Stroke

Akremi et. al.; 2021 [220]

Patients affected by stroke (19; 61.6 ± 14.4 years); Healthy control (20; 51 ± 14.9 years)

Assess kinematic and kinetic parameters for upper limb co-ordination during a bilateral pushing task

The paretic side displayed considerable lag (p < 0.01) and lower forces (p < 0.01) than the non-paretic side

Level IV

Assadi et. al.; 2022 [221]

Patients affected by stroke (82; 71 years) assessed three times post stroke; No healthy control

Assess longitudinal changes in function, dexterity, grip strength, and self-perception of the less-affected UE and determine the association of both UEs to ADL during the first 6 months poststroke

Dexterity improved significantly in 6 weeks (P < 0.001) and grip strength improved significantly between 6 weeks and 6 months post-stroke (p < 0.01)

Level II

Bailey et. al.; 2015 [222]

Patients affected by stroke (48; 59.7 ± 10.9 years); Healthy control (74; 54.3 ± 11.3 years)

Quantify real-world bilateral upper-limb activity in nondisabled adults and adults with stroke using a recently developed accelerometry-based methodology

Nondisabled adults demonstrated equivalent use of dominant and

nondominant upper limbs. Bilateral UE activity intensity was lower (P < .001) and more lateralized in adults with stroke (P < .001)

Level I

Bailey et. al.; 2015 [223]

Patients affected by stroke (46; 60 ± 11 years); No healthy control

Characterize affected UE activity and examine potential modifying factors of affected UE activity in community-dwelling adults with chronic stroke

Hours of affected and unaffected UE activity were strongly correlated. Increased severity of motor dysfunction and dependence in ADLs were associated with decreased affected UE activity

Level I

Basilio et. al.; 2021 [224]

Patients affected by stroke (14; 54 ± 11 years); Healthy control (12; 55 ± 9 years)

Investigate UE energy demand during unilateral arm crank submaximal exercise testing in individuals with stroke compared with healthy controls

The energy demand of the paretic side compared with the nonparetic side of the stroke group was greater than the dominant compared with the nondominant side of the control group (p = 0.005)

Level III

Bertrand et. al.; 2003 [225]

Patients affected by stroke (15; 52 ± 12.4 years); Healthy control (15; 47.7 ± 11.5 years)

Verify whether subjects with hemiparesis produced asymmetrical forces during a bilateral submaximal grip task and whether this asymmetry is related to weakness of the paretic limb

In subjects with hemiparesis, the force ratios in the bilateral task were related to the ratios of maximal voluntary forces (p < 0.013). Severely weak hemiparetic subjects produced lower force ratios than mildly weak hemiparetic subjects and healthy subjects (p < 0.001)

Level III

Biryukova et. al.; 2022 [226]

Patients affected by stroke (24; 55.41 ± 10.84 years); No healthy control

Study the dependence of poststroke motor impairments of paretic and non-paretic arm on lesion lateralization, and paresis severity

The joint torques of the non-paretic arm were greater in the case of left hemispheric lesions, characterized by more pronounced asymmetry of joint torques than in right hemispheric lesions

Level IV

Buxbaum et. al.; 2001 [227]

Patients with a Unilateral Right Hemisphere Stroke (8; 66.8 ± 11.9 years); Healthy control (12; 60.2 ± 12.6 years)

Study that, for a reaching task, a left–right asymmetry in treatment group is dependent on distractor stimuli, which competes with the target for control of action, Hence, increasing motor response time in the patients

Treatment group showed slower response due to distractors on the right of the hand, but faster response due to distractors on the left (p < 0.05). Left–right selection asymmetry in neglect may be hand centered

Level III

Cai et. al.; 2019 [228]

Patients affected by stroke (15; 57 ± 11 years); Healthy control (15; 57 ± 10 years)

Determine whether stroke affected how accurately individuals with stroke perceive their self-generated torques during a single-arm task

Participants matched torques at each elbow, for each target torque and movement direction, with a similar accuracy and precision to controls, regardless of the arm tested (p > 0.050)

Level III

Calautti et. al.; 2006 [229]

Patients affected by stroke (20; 61 ± 10 years); Healthy control (20; 58 ± 10 years)

Quantify the ability of stroke patients to finger tap in rhythm with auditory cues given at physiological rate

Regularity Index of their affected hand was significantly worse compared to their unaffected hand and to age-matched controls (p < 0.05 and p < 0.01, respectively)

Level III

Chae et al.; 2002 [230]

Patients affected by stroke (26; 51 ± 15.6 years); No healthy control

Describe the relationship between poststroke UE muscle weakness and cocontraction, and clinical measures of upper limb motor impairment and physical disability

The strength of muscle contraction was significantly stronger in the nonparetic limb (p < 0.001). The strength of muscle contraction in the paretic limb correlated significantly with the clinical measures

Level IV

Dash et. al.; 2019 [231]

Patients affected by stroke (8; 43 ± 8.15 years); Healthy control (12; 35 ± 8 years)

Investigate the measure of post-stroke spasticity affecting grip-strength through quantification of interaction between antagonist and agonist muscles using complexity analysis of EMG signals during isometric grip in healthy and post-stroke participants

EMG signals were significantly different (p < 0.05) between paretic and non-paretic hands of post-stroke participants

Level III

de Lucena et. al.; 2017 [232]

Patients affected by stroke (9; 56.1 ± 14.9 years); No healthy control

Characterize the relationship between kinematic and conventional measures of jerk and acceleration asymmetry, and UE recovery in the treatment group

The non-affected limb showed a significantly greater activity time ratio (p < 0.001), lower average acceleration (p < 0.01), and lower average jerk magnitude (p < 0.01)

Level IV

de Niet et. al.; 2007 [233]

Stroke patients with FMA < 45 (8; 56.1 ± 13 years), FMA > 45 (10; 52.1 ± 13.9 years); Healthy control (5; 43 ± 13.2 years)

Evaluate the Stroke Upper-Limb Activity Monitor to measure the amount of upper limb usage to differentiate between the two treatment groups and the control groups

The level of usage of the affected upper limb of stroke patients was lower than that of the nondominant upper limb of control subjects (electrogoniometry p < 0.01; accelerometry p < 0.01). Stroke patients had higher asymmetry than control subjects in both electrogoniometry (p < 0.01) and accelerometry (p < 0.01). Well-recovered stroke patients had significantly lower asymmetry compared with moderately recovered patients on both electrogoniometry and accelerometry

Level III

Gebruers et. al.; 2008 [234]

Patients affected by stroke (39; 73.8 ± 10 years); No healthy control

Investigate disuse of the impaired arm in acute stroke patients using actigraphy

Actigraphy was able to reliably discriminate less impaired from more impaired stroke patients (p < 0.001). Actigraphy was moderately correlated with AHA (positive) and NIHSS (negative)

Level II

Gosser et. al.; 2015 [235]

Patients affected by stroke (12; 57.75 ± 8.48 years); Healthy control (13; 58.62 ± 8.39 years)

Investigate movement efficiency in people with and without stroke during both unimanual and bimanual upper extremity reaching tasks

The unimpaired limb accommodated its movements to that of the less efficient paretic limb during bimanual conditions. The impaired limb’s performance did not differ between the unimanual and bimanual conditions (P > 0.05)

Level III

Gurari et. al.; 2017 [236]

Patients affected by stroke (14; 57.79 ± 7.04 years); Healthy control (9; 56.2 ± 6.8 years)

Investigate whether individuals with chronic stroke who have impairments mirroring arm positions also have impairments identifying the location of each arm in space

Participants with stroke had greater errors than the controls in both their paretic and non-paretic arm when matching positions during passive movements; yet stroke participants performed comparable to the controls during active movements

Level IV

Harris et. al.; 2006 [237]

Patients affected by stroke (93; 68.7 ± 9.4 years); No healthy control

Determine if UE impairment and function in individuals with chronic stroke is dependent upon whether the dominant or nondominant hand is affected

Affected side (dominant or nondominant) was a significant factor in UE function (p = 0.01)

Level II

Hollis et. al.; 2021 [238]

Children with stroke (30; 11.17 ± 3.83 years); Healthy control (23; 11.08 ± 4.42 years)

Evaluate the efficacy of bilateral actigraphy to quantify UE movement in children with perinatal stroke and HCP

Stroke participants demonstrated higher asymmetry. The strongest correlations were observed between the Block Ratio and the AHA and MA (r = 0.93 and 0.87 respectively)

Level III

Hu et. al.; 2007 [239]

Patients affected by stroke (8; 36 to 59 years); Healthy control (5; 23 to 31 years)

Investigate the properties of MMG, or muscle sound, of the paretic muscle in the affected side of hemiplegic subjects after stroke during isometric voluntary contractions

Both the MMG and EMG RMS values in the healthy and unaffected groups were found to be significantly higher than the affected group (P < 0.05)

Level IV

Iacovelli et. al.; 2019 [240]

Patients affected by stroke (20; 69.2 ± 10.1 years); Healthy control (17; 70.5 ± 7.3 years)

Verify if the actigraphic AI, as calculated by Rabuffetti, can identify the paretic arm of acute stroke patients; verify if such AI can properly quantify the clinical severity of acute stroke patients in the very particular environment of a stroke unit

Both asymmetry indices used were smaller in the paretic than in the unaffected arm (p = 0.004). Asymmetry rate index was greater in stroke patients than in controls and positively correlated with NIHSS total scores

Level III

Johnson et. al.; 2021 [241]

Patients affected by stroke (20; 62.3 ± 7.6 years); Healthy control (10; 566.8 ± 9 years)

Compare fine and gross motor hand dexterity of the ipsilesional hand post-stroke with controls, normative values, and the contralesional hand

Individuals with stroke demonstrated poorer performance with the ipsilesional arm relative to both the control group and the normative values. Ipsilesional arm performance was significantly better than performance with the contralesional arm

Level III

Johnson et. al.; 2022 [242]

Patients with a Unilateral RHD (15; 60.67 ± 1.8 years); Unilateral LHD (15; 64.2 ± 1.83 years); Healthy control (10; 60.2 ± 2.18 years)

Assess the effects of stroke in the right vs. the left hemisphere on how bimanual tasks modify affected and non-affected arm performance and coordination

Individuals with stroke displayed poor grasp and pick-up coordination compared to heathy controls (p < 0.05). The LHD group showed more deficits in grasp coordination

Level III

Kang et. al.; 2014 [243]

Patients affected by stroke (9; 64.2 ± 18.8 years); Healthy control (9; 67.6 ± 13.8 years)

Investigate force variability generated by both the paretic and non-paretic hands during bimanual force control

Greater bimanual force variability in the stroke group than the control group (p < 0.001) and increased force variability by the paretic hands during bimanual force control in comparison to the non-paretic hands (p < 0.001)

Level IV

Kang et. al.; 2017 [244]

Patients affected by stroke (9; 64.2 ± 18.8 years); Healthy control (9; 73.1 ± 5 years)

Examine bilateral synergies using the uncontrolled manifold approach while individuals in a chronic stage after stroke executed bilateral isometric force control at three submaximal force levels

Decreased bilateral synergies in patients with stroke as compared to controls at 50% of MVC

Level IV

Kantak et. al.; 2016 [245]

Patients affected by stroke (11; 59.63 ± 11 years); Healthy control (10; 61.2 ± 15.79 years)

Investigated how patients with chronic stroke and age-matched controls coordinate their arms while performing symmetric and asymmetric movements to accomplish common task goals compared to independent task goals

Individuals with stroke were less coordinated in space and time during common-goal bimanual actions employing asymmetric arm movements. patients demonstrated lesser contribution of their paretic arm compared to their non-paretic arm during common-goal conditions

Level IV

Kantak et. al.; 2016 [246]

Patients affected by stroke (14; 53 ± 15.4 years); Healthy control (10; 59.75 ± 23.06 years)

Determine bimanual coordination deficits in patients with stroke using 3-dimensional kinematic analyses as they perform naturalistic tasks requiring collaborative interaction of the 2 arms

Patients demonstrated an impaired ability to cooperatively interact their 2 arms for an efficient pickup, leading to longer pickup times

Level IV

Kim et. al.; 2016 [247]

Patients affected by stroke (19; 66.6 ± 6.5 years); Healthy control (19; 66.4 ± 4.8 years)

Investigate the effect of stroke-related constraints on multi-finger force control abilities in a visuomotor task

The impaired hand in the stroke survivors showed deficits in motor performance attributed mainly to lower accuracy and reproducibility as compared to control hands (p < 0.05)

Level III

Koesler et. al.; 2009 [248]

Patients affected by stroke (12; 67 ± 7 years); No healthy control

Investigate the effect of electrical somatosensory stimulation on motor performance of the affected hand

Somatosensory stimulation of the median nerve of the affected hand enhanced the frequency of index finger and hand tapping movements and improved the kinematics of reach-to grasp movements performed with the affected hand, compared with baseline (p < 0.01)

Level IV

Lai et. al.; 2019 [249]

Patients affected by stroke (22; 53.7 ± 9.8 years); Healthy control (16; 23.4 ± 3.4 years)

Analyze the relationship of bimanual force coordination control deficits in both hands with motor and functional performances of the paretic upper extremity in stroke patients

The alternating time from the non-paretic to the paretic hand shorter for stroke patients (p < 0.001). The grip force generated for coordination in the healthy group was significantly greater than that of the stroke group (p < 0.05)

Level III

Lakhani et. al.; 2017 [250]

Less (13; 69.62 ± 5.17 years) and More (9; 59.44 ± 6.96 years) impaired patients affected by stroke; No healthy control

Understand whether MWF in sensorimotor regions of interest is a biomarker of long-term impairment, function, or arm use in a population of individuals living with chronic stroke

There were no relationships between MWF asymmetry ratio and upper-limb use

Level II

Lang et. al.; 2008 [251]

Patients affected by stroke (52; 64 ± 14 years); No healthy control

Estimate minimal clinically significant difference values of several upper-extremity measures early after stroke

ARAT, out of all the measures tested, had the highest MCID score

Level II

Lang et. al.; 2007 [252]

Patients affected by stroke (34; 63.9 ± 14.8 years); Healthy control (10; 59 ± 13 years)

Determine the amount of UE use in people with hemiparesis post stroke during their inpatient rehabilitation stay

Hemiparetic subjects used their affected and unaffected upper extremities substantially less than control subjects; affected UE use is minimal during the inpatient rehabilitation stay

Level II

Lee et. al.; 2015 [253]

Patients affected by stroke (13; 65.64 ± 7.35 years); Healthy control (13; 65.59 ± 9.4 years)

Compare force modulation below 1 Hz in chronic stroke and age-matched healthy individuals

Force modulation below 1 Hz differentiated the stroke individuals and healthy controls (p < 0.01), as well as the paretic and non-paretic hands (p < 0.05). Similarly, the paretic hand exhibited greater power at 0.2 Hz, and lesser power at 0.6 Hz than the nonparetic hand

Level IV

Lee et. al.; 2020 [254]

Patients affected by stroke (29; 58.87 ± 11.83 years); No healthy control

Compare the differences in the amount of activity of the nondominant and dominant affected hands among patients with poststroke right hemiparesis

The asymmetry and differential activity of both hands were worse in the patients with poststroke right hemiparesis, whose dominant hand was affected

Level II

Lewis et. al.; 2004 [255]

Patients affected by stroke (9; 56 ± 12 years); Healthy control (9; 54 ± 9 years)

Examine intralimb coordination in a frequency-scaled task completed in unimanual and bimanual conditions

Trajectory variability was higher in the stroke group (p < 0.001). The impaired hand showed higher variability than the nonimpaired hand

Level IV

Li et. al.; 2003 [256]

Patients affected by stroke (16; 26 to 87 years); Healthy control (16; 25 to 86 years)

Investigate changes in finger interaction after stroke with strongly unilateral motor effects. Effects of age on finger interaction were also analyzed

Peak forces produced by the fingers of the impaired hand were about 36% less than those produced by the unimpaired hand (p < 0.001). Two-hand tasks were accompanied by an additional drop in the force of individual fingers

Level III

Lodha et. al.; 2012 [257]

Patients affected by stroke (12; 64.88 ± 8.07 years); Healthy control (12; 66.67 ± 9.39 years)

Investigate the influence of task constraints on bimanual force control strategies poststroke

The paretic hand contributed less force than the non-paretic hand in finger extension whereas this relationship was reversed in power grip. Reduction in motor impairments was associated with increased symmetry and coordination in bimanual tasks

Level III

Lodha et. al.; 2012 [258]

Patients affected by stroke (10; 64.87 ± 8.07 years); Healthy control (10; 66.66 ± 9.36 years)

Determine the asymmetry and coordination of force output during a bimanual isometric task with a common goal in chronic stroke relative to age-matched controls

The stroke group demonstrated greater asymmetry and reduced coordination in force produced by each hand. Bimanual force coordination increased at higher forces in controls but not in stroke

Level III

Maenza et. al.; 2020 [259]

Patients affected by stroke on the left (48; 60.28 years) and on the right (64; 59.12 years); Healthy control (54; 65.59 ± 9.4 years)

Examine whether functional motor deficits in the less-affected arm, measured by standardized clinical measures of motor function, also depend on the hemisphere that was damaged and on the severity of contralesional impairment

Ipsilesional limb functional performance deficits varied with both the damaged hemisphere and severity of contralesional arm impairment, with the most severe deficits expressed in LHD participants with severe contralesional impairment

Level II

McCrea et. al.; 2003 [260]

Patients affected by stroke (20; 60.9 ± 6.1 years); Healthy control (10; 61 ± 9 years)

Assess muscle strength and time-dependent properties of muscle contraction in persons affected with stroke

All parameters were impaired in the more affected arm, whereas peak torque and time to develop torque were impaired in the less affected arm

Level III

Metrot et. al.; 2013 [261]

Patients affected by stroke (12; 63.7 ± 9.7 years); No healthy control

Assess the natural evolution of reaching kinematics during standard poststroke rehabilitation, focusing on bimanual coordination

For the paretic limb, amount of movement was lower for bimanual reaching compared with unimanual reaching (p < 0.05). For bimanual reaching, movement kinematics were similar for both limbs (p = 0.589)

Level IV

Morris et. al.; 2012 [262]

Patients affected by stroke (56; 67.8 ± 13.1 years); Healthy control (50; 67.8 ± 9.9 years)

Investigate effects of bilateral training on ipsilesional arm dexterity and activity limitation, Explore the relationships between contralesional and ipsilesional recovery

The bilateral training group demonstrated significantly greater change in dexterity (P > 0.03) during the intervention phase. There was no significant correlation between ipsilesional and contralesional recovery

Level I

Noskin et.al.; 2008 [263]

Patients affected by stroke (30; 61.5 ± 11.3 years); No healthy control

Investigate ipsilateral hand performance after hemiparetic stroke, starting in the early post-stroke period

The initial degree of impairment of grip strength in the contralateral hand did not correlate with the degree of impairment of 9HPT in either the contralateral or ipsilateral hand (p = 0.98), whereas the initial degree of impairment of 9HPT in the contralateral hand correlated with the degree of impairment of 9HPT in the ipsilateral hand (p = 0.035)

Level IV

Olczak et. al.; 2022 [264]

Patients affected by stroke (60; 65.3 ± 14.43 years); No healthy control

Analyze the effect of the position of the trunk and the affected upper limb on the coordination and grip strength of the affected dominant and non-dominant hand and wrist in people after ischemic stroke

Higher and relevant results were observed in the non-dominant hand, in the supine position in terms of motor coordination parameters of the fingers and wrist, and grip strength (p < 0.05)

Level II

Patel et. al.; 2019 [265]

Patients affected by stroke (13; 68.04 ± 12.17 years); Healthy control (13; 69.79 ± 7.94 years)

Investigate the impact of stroke on dynamic bimanual force control and compare the contribution of each hand to a bimanual task

The proportion of force contributed by the non-paretic hand reduced and force variability of the non-paretic hand increased during the force decrement phase

Level IV

Pohl et. al.; 2000 [266]

Patients with stroke affecting their right (10; 71.7 ± 13.7 years) & left side (10; 67.2 ± 13.3 years) & (10; 68.7 ± 8.1 years); No healthy control

Investigate whether motor control deficits are present in the ipsilateral UE when there is mild impairment in the contralateral UE

The ipsilateral UE of just the stroke patients with left brain damage presented control deficits (p < 0.05)

Level III

Pollet et. al.; 2022 [267]

Patient affected by stroke with a low grip strength (10; 64.2 ± 15.9 years) and a high grip strength ≥ 45 (11; 68.4 ± 7.8 years); Healthy control (10; 67.1 ± 7.8 years)

Determine how grip strength capacity of the paretic hand influences its contribution to

bimanual tasks

The amount of force contributed by the paretic hand increased in bimanual tasks with an increase in its grip strength capacity (p < 0.01). In the bimanual MVC task and bimanual force control task, both hands contributed equal magnitudes of force in the high strength-capacity group but unequal forces in low strength-capacity group

Level III

Prados-Roman et. al.; 2020 [268]

Patients affected by stroke (20; 56.95 ± 14.09 years); Healthy control (20; 57.1 ± 13.22 years)

Evaluate maximal handgrip strength, fatigue resistance, grip work, and muscle fatigue in mildly affected stroke persons

Persons with stroke demonstrated significantly reduced handgrip performance regarding maximal handgrip strength, resistance to fatigue, grip work, and muscle fatigue for the contralesional hand

Level III

Reale et. al.; 2021 [269]

Patients affected by stroke (20; 69.2 ± 10.1 years); No healthy control

(1) Analyze the correlation between the actigraphic index and the severity of 90-day disability as quantified by the mRS

(2) Establish the ability of the AR24H index to predict 90-day disability preliminarily

The actigraphic AI positively correlates with the 90-day mRS (p < 0.001)

Level II

Rinehart et. al.; 2009 [270]

Patients with RHD (12; 59.2 ± 9.9 years) & LHD (17; 65.1 ± 11.9 years); Healthy control (25; 64 ± 8.3 years)

Determine if right hand preference influences the relative use of each limb after stroke

(1) Ipsilesional arm use was greater after RHD than LHD; (2) the LHD group used both arms together more often than the RHD group but less often than the control group; and (3) both stroke groups used their contralesional, paretic arm to the same degree

Level II

Rose et. al.; 2005 [271]

Patients affected by stroke (30; 63 years); Healthy control (30; 67 years)

Determine the role of anticipatory and movement control processes for the coordination of bimanual target aiming in individuals post stroke

The nonparetic limb exhibited a prolonged movement time in the bimanual condition. Compared with the unimanual condition, the nonparetic limb exhibited a lower peak velocity in the bimanual condition (p < 0.05)

Level III

Rose et. al.; 2013 [272]

Patients affected by stroke (30; 63.17 ± 12.17 years); 30 healthy controls (no demographics data)

Quantify interlimb coordination strength and compare individuals with asymmetric effector ability poststroke to nondisabled controls

Interlimb coupling was significantly stronger for the nondisabled compared to the stroke group

Level III

Siekierka-Kleiser et. al.; 2006 [273]

Patients affected by stroke (52; 62 ± 14 years); Healthy control (9; 60 ± 8 years)

Investigate whether the recovery dynamics of hemiparetic patients with motor hemineglect are different from those in hemiparetic patients without motor hemineglect

Patients without motor hemineglect showed an increase in spontaneous movement activity (p < 0.05), while patients with motor hemineglect showed no such increase (p > 0.1)

Level II

Soares et. al.; 2015 [274]

Patients affected by stroke (42; 61.7 ± 10 years); No healthy control

Verify if the functional hemispheric asymmetry plays an influence over the deficits of upper limbs of hemiparetic stroke patients, as well as if these possible alterations are different between men and women

The tests performed showed a difference between the paretic and non-paretic sides (p < 0.05). Hemispheric dominance was different in the paretic limb, with the best performance in BBT on the dominant side (p = 0.016)

Level II

Song et. al.; 2013 [275]

Patients affected by stroke (8; 45 ± 11 years); No healthy control

Investigate the parameters during voluntary arm tracking at different velocities for evaluating motor control performance after stroke

The affected and unaffected sides were different during the arm tracking experiment (P < 0.05)

Level IV

Toba et. al.; 2021 [276]

Patients affected by stroke (35; 59.16 ± 13.79 years); No healthy control

Introduce an objective and quantitative assessment method for MN, based on differential actigraphy which provides continuous assessment of spontaneous movements over 24 h

Differential actigraphy showed asymmetrical activity corresponding with the side of hemispheric brain damage suggesting unilateral elementary motor disorders, MN, or both disorders in these patients

Level II

Uswatte et. al.; 2000 [277]

Patients affected by stroke (9; 54.4 ± 19.5 years); Healthy control (12; 21 ± 2.5 years)

Evaluate whether transforming accelerometer recordings with a threshold filter provides an objective measure of the duration of arm movement when patients are outside the laboratory and cannot be directly observed by experimenters or clinicians

Correlations between the threshold-filtered recordings and the observer ratings of the duration of arm, torso, and ambulatory movements were 0.93, 0.93 and 0.99, respectively

Level IV

Uswatte et. al.; 2006 [278]

Patients affected by stroke (82; 63 ± 12.8 years); Healthy control (87; 64.2 ± 12.7 years)

Test whether the ratio of impaired-arm to unimpaired-arm accelerometer recordings converges with measures of real-world, impaired-arm use and diverges from a measure of overall physical activity

Correlations calculated across all participants at baseline between the ratio of more-impaired to less-impaired arm accelerometer recordings and AAUT and MAL scores were .60 and .52, respectively

Level I

Varghese et. al.; 2020 [279]

Patients affected by stroke (42; 59.16 ± 12.3 years); No healthy control

Investigate the relationship between the motor capacities of the two hands differs based on the side of stroke

Compared to RHD, the relationship between contralesional arm impairment and ipsilesional hand motor capacity was stronger (p = 0.03) in LHD

Level II

McCombe Waller et. al.; 2006 [280]

Patients affected by stroke (16; 59 ± 12.62 years); No healthy control

Examine the characteristics of bilateral simultaneous and bilateral sequential paretic-lead and nonparetic-lead functional reaching tasks at preferred and fast speeds

Despite hemiparesis, the two arms demonstrate a temporal coupling when moving simultaneously. At faster speeds, paretic arm's movement time was better when reaching with or before the non-paretic arm

Level IV

Whitford et. al.; 2018 [281]

Patients affected by stroke (8; 57.03 ± 6.64 years); No healthy control

Determine the effects of in-home high dose accelerometer-based feedback on (1) perception of paretic UE use; (2) actual paretic UE use; and (3) capability in individuals’ chronic post-stroke in the home setting

Participants had significant perceived gains in how much (p = 0.017) and how well (p = 0.050) they used the paretic UE. There were no significant group changes in actual paretic UE AOU or capability

Level II

Yang et. al.; 2021 [282]

Patients affected by stroke (14; 60.97 ± 11.9 years); Healthy control (14; 59.31 ± 10.58 years)

Measure functional grasp movements in individuals with chronic stroke and healthy controls throughout all activities over multiple days using a novel wrist-worn device

A larger AI (p = .01) of the affected hand in the stroke group were found compared to that of the nondominant hand in the control group

Level III