Effect of mirror therapy on upper extremity motor function in stroke patients: a randomized controlled trial

Abstract

[Purpose] This study aimed to evaluate the effectiveness of mirror therapy combined with a conventional rehabilitation program on upper extremity motor and functional recovery in stroke patients. [Subjects and Methods] Thirty-one hemiplegic patients were included. The patients were randomly assigned to a mirror (n=16) or conventional group (n=15). The patients in both groups underwent conventional therapy for 4 weeks (60–120 minutes/day, 5 days/week). The mirror group received mirror therapy, consisting of periodic flexion and extension movements of the wrist and fingers on the non-paralyzed side. The patients in the conventional group performed the same exercises against the non-reflecting face of the mirror. The patients were evaluated at the beginning and end of the treatment by a blinded assessor using the Brunnstrom stage, Fugl-Meyer Assessment (FMA) upper extremity score, and the Functional Independence Measure (FIM) self-care score. [Results] There was an improvement in Brunnstrom stage and the FIM self-care score in both groups, but the post-treatment FMA score was significantly higher in the mirror therapy group than in the conventional treatment group. [Conclusion] Mirror therapy in addition to a conventional rehabilitation program was found to provide additional benefit in motor recovery of the upper extremity in stroke patients.

Effectiveness of mirror therapy in the motor recovery of upper extremity in the post stroke hemiplegic patients: a randomized controlled trial in a tertiary care hospital in Manipur, Northeast India

“…16 In this study also males had higher incidence of stroke with a ratio of 1.5:1. Similar findings were observed in other studies conducted by Gurbuz N et al, and Dhamija et al 17,18 Yavuzer G et al, studied the effect of mirror therapy (5 days a week, 2-5 hours/day) in 36 patients with subacute stroke found significant improvement in the hand and upper extremity Brunnstrom stages and the FIM self-care scores compared to the control group. 12 This significant difference was still evident at the 6-month follow-up.…”

Mirror therapy for motor function of the upper extremity in patients with stroke: A meta-analysis

“…It commonly causes partial or total impairment of motor function of the upper extremity in survivors (5). More than 50% of stroke survivors have impairment of motor function of the upper extremity (6,7) that seriously affects their life (8). There is clearly a need for stroke survivors to rebuild upper extremity motor function (9).…”

“…However, the sample size was small (9 participants) and outcome measurement was by subjective comments from patients, which may significantly impact on the generalizability of the result (20). Following Altschuler et al's study (18), further studies of MT in patients with stroke found that it had a positive effect on recovery of motor function of the upper limb (8,16,(21)(22)(23)(24)(25)(26)(27). However, the mechanism of MT is not clearly understood (28).…”

“…In recent years, an increasing number of randomized controlled trials (RCTs) have been performed to examine the effectiveness of MT on motor function of the upper limb in stroke patients (8,16,(21)(22)(23)(24)(25)(26)(27). The mean treatment effect size of MT remains unclear (33), however, due to small sample size (20), and various characteristics of the target samples (i.e.…”

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“…Having the mirror neuron network as a substrate, this therapeutic approach was designed for the reactivation of brain plasticity, with the aim of restoring lost functions and preserving residual functions. The starting point was the hypothesis that the movements of a limb visualized in front of a mirror trigger neuronal connections in the motor cortex concerned (Gurbuz et al, 2016). Neurophysiological and imaging studies using functional MRI were conducted in healthy human subjects, which demonstrated that the excitability of the primary motor cortex increases when the image of one's own moving hand in the mirror is watched (Kim et al, 2016), which supports the idea of neuroplasticity modulation by applying this therapy.…”