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HOLISTIC STROKE SOLUTIONS: Why you should do this exercise Quadrupedal Training After Stroke: Re-linking the Hemispheres https://www.drarjankuipers.com Pre-order the machines at: https://brainrehabfitness.com Quadrupedal, cross-crawl style training (hands-and-knees work, supported arm–leg cycling, reciprocal stepping) is a powerful way to re-engage “whole-brain, whole-body” networks after stroke. Many survivors develop an interhemispheric imbalance—the “better” hemisphere over-inhibits the lesioned side via transcallosal pathways, which can suppress recovery on the affected side. Bilateral, rhythmic, whole-body tasks help rebalance that inhibition while tapping into preserved spinal and propriospinal patterning that couples arms and legs. PubMed+1 Why quadrupedal patterns? Human locomotion leverages central pattern generators (CPGs) and reflexogenic interlimb networks in the spinal cord and brainstem. These networks coordinate arms and legs and often remain accessible after stroke, meaning we can recruit them with natural, rhythmic, cross-body movement to “wake up” suppressed circuits. PubMed+2PMC+2 What the evidence shows • After stroke, abnormal transcallosal inhibition from the intact to the lesioned motor cortex can hinder the paretic limb—part of the classic “interhemispheric competition” model. PubMed+1 • The brain sometimes reorganizes with ipsilateral/contralesional control (especially for proximal muscles), which can be helpful or maladaptive depending on severity—another reason to use bilateral tasks that promote better interhemispheric balance. Frontiers+1 • Bilateral movement training (e.g., BATRAC) improves upper-limb function on average and may help normalize interhemispheric inhibition; recent work suggests bilateral rhythmic training can specifically influence IHI metrics. PubMed+2Frontiers+2 • Training the arms can help the legs: rhythmic arm cycling improved walking and neurophysiology in chronic stroke, consistent with strong arm–leg coupling. PMC How we use it at Stroke.Fitness / Stroke.Rehab We start from quadrupedal baselines—hands-and-knees rocking, cross-crawl patterns, supported arm–leg cycling/recumbent stepping, and reflex-priming tasks—then progress to upright gait and task-specific training. The aim is to disinhibit the affected hemisphere, re-synchronize networks, and translate those gains into walking, hand use, and balance. When progress stalls, this becomes our go-to reset because it leverages robust, conserved circuitry rather than compensation alone. 👉 Want a tailored plan? Book an analysis session with our team. References Boddington, L. J., & Reynolds, J. N. J. (2017). Targeting interhemispheric inhibition with neuromodulation to enhance stroke rehabilitation. Brain Stimulation, 10(2), 214–222. https://doi.org/10.1016/j.brs.2016.11... PubMed+1 Bradnam, L. V., Stinear, C. M., & Byblow, W. D. (2013). Ipsilateral motor pathways after stroke: Implications for non-invasive brain stimulation. Frontiers in Human Neuroscience, 7, 184. https://www.frontiersin.org/articles/... Frontiers Cauraugh, J. H., Lodha, N., Naik, S. K., & Summers, J. J. (2010). Bilateral movement training and stroke motor recovery: A structured review and meta-analysis. Neuropsychologia, 48(8), 1946–1957. https://pubmed.ncbi.nlm.nih.gov/19926... PubMed Chen, S., Leng, Y., Li, S., et al. (2022). Effectiveness and success factors of bilateral arm training after stroke: A systematic review. Frontiers in Aging Neuroscience, 14, 875794. https://www.frontiersin.org/articles/... Frontiers Kaupp, C., Pearcey, G. E. P., Klarner, T., et al. (2018). Rhythmic arm cycling training improves walking and neurophysiological integrity in chronic stroke. Journal of Neurophysiology, 119(3), 1095–1112. https://www.ncbi.nlm.nih.gov/pmc/arti... PMC Klarner, T., Barss, T. S., Sun, Y., Kaupp, C., & Zehr, E. P. (2014). Preservation of common rhythmic locomotor control despite weakened supraspinal regulation after stroke. Frontiers in Integrative Neuroscience, 8, 95. https://pubmed.ncbi.nlm.nih.gov/25565... PubMed Mirdamadi, J. L., Tinaz, S., Cummings, N., & Almeida, Q. J. (2023). State-dependent interhemispheric inhibition reveals circuit dysfunction after stroke. Clinical Neurophysiology, 149, 127–138. https://www.drarjankuipers.com Pre-order the machines at: https://brainrehabfitness.com https://www.stroke.rehab