Bimanual motor skill learning in patients with chronic stroke: impairments, rehabilitation with the Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) and brain damage correlations

Stroke induces long-term impairments, limitations and restrictions on daily life. In line with current neurorehabilitation guidelines, this thesis interrogates bimanual motor skill learning (BimMSkL) in adults with chronic stroke across impairment assessment, intensive therapy, and neural substrates. Specifically, it aims to: (i) determine whether—and how—hemiparetic individuals with chronic stroke achieve BimMSkL compared with healthy individuals; (ii) test the efficacy of Hand–Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE), a high-dose intervention grounded in motor skill learning principles, across all three ICF domains; (iii) assess whether HABIT-ILE enhances bimanual control and BimMSkL capacities quantified using kinematics; and (iv) identify neural substrates that predict HABIT-ILE responsiveness and/or successful BimMSkL using voxel-based lesion–symptom mapping.