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.

Assessment of the Effectiveness of Facial Expression Exercises Stimulation Using Mirror Media in Increasing Facial Muscle Strength in Hemiparetic Stroke Patients

“…This finding aligns with the previous study, which explained that a mirror therapeutic intervention conveys visual stimuli to the brain through observing normal body parts when individuals perform a series of movements. This finding is also in line with the results of previous studies, which explained that mirror therapy is an effective approach to improve motor function, sensory function, and at least as an adjunct to conventional rehabilitation in post-stroke patients in the acute, sub-acute, and chronic stroke phases compared to the conventional treatment group [16], [17], [18].…”

Assessment of the Effectiveness of Facial Expression Exercises Stimulation Using Mirror Media in Increasing Facial Muscle Strength in Hemiparetic Stroke Patients

“…This finding aligns with the previous study, which explained that a mirror therapeutic intervention conveys visual stimuli to the brain through observing normal body parts when individuals perform a series of movements. This finding is also in line with the results of previous studies, which explained that mirror therapy is an effective approach to improve motor function, sensory function, and at least as an adjunct to conventional rehabilitation in post-stroke patients in the acute, sub-acute, and chronic stroke phases compared to the conventional treatment group [16], [17], [18].…”

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 and self-care autonomy after stroke: an intervention program

“…In addition, Thieme, Bayn, et al (2012) noted that the results have to be interpreted with caution due to the small sample size. Despite the gains in the degree of independence, the results were similar to those found by Thieme, Bayn, et al (2012) and Gurbuz et al (2016), who suggested that mirror therapy had no impact on self-care due to the lack of statistically significant differences between groups observed using the Barthel Index and the Functional Independence Measure (FIM), respectively. According to Gurbuz et al (2016), this finding may be due to the small sample size, the short duration of mirror therapy, and the fact that the majority of participants in their study had severe hemiparesis (Brunnstrom stage I or II).…”

“…Despite the gains in the degree of independence, the results were similar to those found by Thieme, Bayn, et al (2012) and Gurbuz et al (2016), who suggested that mirror therapy had no impact on self-care due to the lack of statistically significant differences between groups observed using the Barthel Index and the Functional Independence Measure (FIM), respectively. According to Gurbuz et al (2016), this finding may be due to the small sample size, the short duration of mirror therapy, and the fact that the majority of participants in their study had severe hemiparesis (Brunnstrom stage I or II). With the exception of the positive effect on visuospatial neglect found by Thieme, Bayn, et al (2012), all other findings on functional recovery were corroborated in this study, which found no differentiating effect or significant gains from using the mirror therapy, thus confirming that the functional recovery of the paretic upper limb and the performance of ADL are directly proportional (Park et al, 2015).…”

Assessment of the Effectiveness of Facial Expression Exercises Stimulation Using Mirror Media in Increasing Facial Muscle Strength in Hemiparetic Stroke Patients

“…This finding aligns with the previous study, which explained that a mirror therapeutic intervention conveys visual stimuli to the brain through observing normal body parts when individuals perform a series of movements. This finding is also in line with the results of previous studies, which explained that mirror therapy is an effective approach to improve motor function, sensory function, and at least as an adjunct to conventional rehabilitation in post-stroke patients in the acute, sub-acute, and chronic stroke phases compared to the conventional treatment group [16], [17], [18].…”

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 and self-care autonomy after stroke: an intervention program

“…In addition, Thieme, Bayn, et al (2012) noted that the results have to be interpreted with caution due to the small sample size. Despite the gains in the degree of independence, the results were similar to those found by Thieme, Bayn, et al (2012) and Gurbuz et al (2016), who suggested that mirror therapy had no impact on self-care due to the lack of statistically significant differences between groups observed using the Barthel Index and the Functional Independence Measure (FIM), respectively. According to Gurbuz et al (2016), this finding may be due to the small sample size, the short duration of mirror therapy, and the fact that the majority of participants in their study had severe hemiparesis (Brunnstrom stage I or II).…”

“…Despite the gains in the degree of independence, the results were similar to those found by Thieme, Bayn, et al (2012) and Gurbuz et al (2016), who suggested that mirror therapy had no impact on self-care due to the lack of statistically significant differences between groups observed using the Barthel Index and the Functional Independence Measure (FIM), respectively. According to Gurbuz et al (2016), this finding may be due to the small sample size, the short duration of mirror therapy, and the fact that the majority of participants in their study had severe hemiparesis (Brunnstrom stage I or II). With the exception of the positive effect on visuospatial neglect found by Thieme, Bayn, et al (2012), all other findings on functional recovery were corroborated in this study, which found no differentiating effect or significant gains from using the mirror therapy, thus confirming that the functional recovery of the paretic upper limb and the performance of ADL are directly proportional (Park et al, 2015).…”

Assessment of the Effectiveness of Facial Expression Exercises Stimulation Using Mirror Media in Increasing Facial Muscle Strength in Hemiparetic Stroke Patients

“…This finding aligns with the previous study, which explained that a mirror therapeutic intervention conveys visual stimuli to the brain through observing normal body parts when individuals perform a series of movements. This finding is also in line with the results of previous studies, which explained that mirror therapy is an effective approach to improve motor function, sensory function, and at least as an adjunct to conventional rehabilitation in post-stroke patients in the acute, sub-acute, and chronic stroke phases compared to the conventional treatment group [16], [17], [18].…”

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 and self-care autonomy after stroke: an intervention program

“…In addition, Thieme, Bayn, et al (2012) noted that the results have to be interpreted with caution due to the small sample size. Despite the gains in the degree of independence, the results were similar to those found by Thieme, Bayn, et al (2012) and Gurbuz et al (2016), who suggested that mirror therapy had no impact on self-care due to the lack of statistically significant differences between groups observed using the Barthel Index and the Functional Independence Measure (FIM), respectively. According to Gurbuz et al (2016), this finding may be due to the small sample size, the short duration of mirror therapy, and the fact that the majority of participants in their study had severe hemiparesis (Brunnstrom stage I or II).…”

“…Despite the gains in the degree of independence, the results were similar to those found by Thieme, Bayn, et al (2012) and Gurbuz et al (2016), who suggested that mirror therapy had no impact on self-care due to the lack of statistically significant differences between groups observed using the Barthel Index and the Functional Independence Measure (FIM), respectively. According to Gurbuz et al (2016), this finding may be due to the small sample size, the short duration of mirror therapy, and the fact that the majority of participants in their study had severe hemiparesis (Brunnstrom stage I or II). With the exception of the positive effect on visuospatial neglect found by Thieme, Bayn, et al (2012), all other findings on functional recovery were corroborated in this study, which found no differentiating effect or significant gains from using the mirror therapy, thus confirming that the functional recovery of the paretic upper limb and the performance of ADL are directly proportional (Park et al, 2015).…”