Associated Mirror Therapy Enhances Motor Recovery of the Upper Extremity and Daily Function after Stroke: A Randomized Control Study

Abstract

Bimanual cooperation plays a vital role in functions of the upper extremity and daily activities. Based on the principle of bilateral movement, mirror therapy could provide bimanual cooperation training. However, conventional mirror therapy could not achieve the isolation of the mirror. A novel paradigm mirror therapy called associated mirror therapy (AMT) was proposed to achieve bimanual cooperation task-based mirror visual feedback isolating from the mirror. The study was aimed at exploring the feasibility and effectiveness of AMT on stroke patients. We conducted a single-blind, randomized controlled trial. Thirty-six eligible patients were equally assigned into the experimental group (EG) receiving AMT and the control group (CG) receiving bimanual training without mirroring for five days/week, lasting four weeks. The Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) for upper extremity motor impairment was used as the primary outcome. The secondary outcomes were the Box and Block Test (BBT) and Functional Independence Measure (FIM) for motor and daily function. All patients participated in trials throughout without adverse events or side effects. The scores of FMA-UL and FIM improved significantly in both groups following the intervention. Compared to CG, the scores of FMA-UL and FIM were improved more significantly in EG after the intervention. The BBT scores were improved significantly for EG following the intervention, but no differences were found in the BBT scores of CG after the intervention. However, no differences in BBT scores were observed between the two groups. In summary, our study suggested that AMT was a feasible and practical approach to enhance the motor recovery of paretic arms and daily function in stroke patients. Furthermore, AMT may improve manual dexterity for poststroke rehabilitation.

Effects of Early Acupuncture Combined with Rehabilitation Training on Limb Function and Nerve Injury Rehabilitation in Elderly Patients with Stroke: Based on a Retrospective Cohort Study

“…The earlier the intervention, the better the effect. The study by Wang and others found that the mirror therapy combined with the conventional rehabilitation training group enhanced the upper limb motor function, daily living ability, and electromyographic signal of stroke patients better than the conventional rehabilitation training group [ 25 ]. Therapy is more conducive to the recovery of patients' limb function and helps patients regain their independent living ability.…”

Non-invasive brain stimulation associated mirror therapy for upper-limb rehabilitation after stroke: Systematic review and meta-analysis of randomized clinical trials

“…By providing normal visual stimulation of bilateral movement, MT has been proven to be effective in enhancing upper limb motor function in stroke patients by many clinical studies ( 8 , 34 , 35 ). Among the non-invasive brain stimulation techniques, the most widely studied are rTMS and tDCS.…”

Emerging Limb Rehabilitation Therapy After Post-stroke Motor Recovery

“…Mirror therapy was first proposed in 1996 and effectively reduced pain in patients with amputated arms ( Ramachandran and Rogers-Ramachandran, 1996 ). Subsequently, studies conducted in stroke patients with hemiplegia after ictus showed that mirror therapy could significantly rehabilitate patients with upper limb motor dysfunction ( Yavuzer et al, 2008 ; Nogueira et al, 2021 ; Zhuang et al, 2021 ). In addition, the role and impact of mirror therapy have also been explored in lower limb motor rehabilitation ( Sütbeyaz et al, 2007 ; Li et al, 2018 ; Louie et al, 2019 ).…”