In contrast to varied therapy approaches, mirror therapy (MT) can be used even in completely plegic stroke survivors, as it uses visual stimuli for producing a desired response in the affected limb. MT has been studied to have effects not just on motor impairments but also on sensations, visuospatial neglect, and pain after stroke. This paper attempts to systematically review and present the current perspectives on mirror therapy and its application in stroke rehabilitation, and dosage, feasibility and acceptability in stroke rehabilitation. An electronic database search across Google, PubMed, Web of Science, etc., generated 3871 results. After screening them based on the inclusion and exclusion criteria, we included 28 studies in this review. The data collected were divided on the basis of application in stroke rehabilitation, modes of intervention delivery, and types of control and outcome assessment. We found that most studies intervened for upper limb motor impairments post stroke. Studies were equally distributed between intervention in chronic and acute phases post stroke with therapy durations lasting between 1 and 8 weeks. MT showed definitive motor and sensory improvements although the extent of improvements in sensory impairments and hemineglect is limited. MT proves to be an effective and feasible approach to rehabilitate post-stroke survivors in the acute, sub-acute, and chronic phases of stroke, although its long-term effects and impact on activities of daily living need to be analysed extensively.
Background and Aims: The use of visual stimuli to facilitate a desired response in the affected limb in mirror therapy (MT) makes it an effective treatment modality even in instances of a complete plegic upper extremity poststroke. This article analyzes the effects of MT on impairments, activity limitation, and participation restriction in the acute and chronic phases poststroke. Methods: In total, 16 out of 3871 studies were included in the meta-analysis, using PRISMA guidelines. Data were categorized based on application in stroke rehabilitation (acute/chronic, motor/sensory/neglect/activity of daily living, upper limb/lower limb), modes and dosage of intervention delivery, types of control, and outcome assessment. RevMan 5.0 software was used for analysis. Results: Studies were equally distributed between chronic and acute phases. Therapy durations lasted between 1 and 8 weeks. Most studies intervened for upper limb motor impairments showing improvement in Brunnstrom motor recovery stages of arm ( P value: .04, 95% CI, 0.05-1.54, I2 = 59%) and hand ( P value: <.001, 95% CI, 0.80-2.01, I2 = 0%) during acute phase (0-4 weeks). “Activity/function” measured by functional independence measure showed improvement only in self-care subsection ( P value: <.001, 95% CI, 2.05-5.16, I2 = 0%). No long-term effects were analyzed in any of the included studies. Conclusion: A significant finding of this study is the role of MT in improving arm and hand impairments in acute phase poststroke. Rehabilitation protocols can be improved based on this finding. As MT is effective, affordable, and feasible, we have made suggestions toward its incorporation in physiotherapy protocols for low- and middle-income countries.
Background:The need for intense rehabilitation protocols with easy applicability to improve for patient adherence and harness the potential neuroplasticity leading to improvement in the quality of life (QOL) in post-stroke patients. Several studies have described the benefits of virtual reality and video games in rehabilitation. Aims: To explore and determine if Computer game-based rehabilitation for post-stroke upper limb deficits after stroke is superior to conventional therapy in terms of (1) ICIDH based outcomes (2) Intervention duration (3) acceptability and adherence to the intervention. Methods: This systematic review and meta-analysis followed PRISMA guidelines. Several electronic databases were searched using specific keywords, to measure the effects of computer-game-based therapy in post-stroke patients compared to conventional therapy. Results: 14 studies were included after a systematic review, out of which 11 were included for analysis. Studies recording Wolf motor function test and box and block test have shown improvements with Computer-game-based therapy in addition to conventional therapy. No improvements were recorded in impairments and patient participation/Quality of life. CGBT was acceptable and reported no adverse effects. Conclusions: Computer-game-based therapy or non-immersive virtual rehabilitation is effective and acceptable for upper limb rehabilitation after stroke. With significant improvement in 'activity-limitation, ' this mode of rehabilitation can be adapted for patient-specific needs. Its effects on impairment and quality of life need further exploration.
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