Effects of mirror therapy combined with motor tasks on upper extremity function and activities daily living of stroke patients

Abstract

[Purpose] The objective of this study was to investigate the effects of mirror therapy combined with exercise tasks on the function of the upper limbs and activities of daily living. [Subjects and Methods] Twenty-five stroke patients who were receiving physical therapy at K Hospital in Gyeonggi-do, South Korea, were classified into a mirror therapy group (n=12) and a conventional therapy group (n=13). The therapies were applied for 30 minutes per day, five times per week, for a total of four weeks. Upper limb function was measured with the Action Research Arm test, the Fugl-Meyer Assessment, and the Box and Block test, and activities of daily living were measured with the Functional Independence Measure. A paired test was performed to compare the intragroup differences between before training and after four weeks of therapy, and an independent t-test was performed to compare the differences between the two groups before and after four weeks of therapy. [Results] In the intragroup comparison, both groups showed significant differences between measurements taken before and after four weeks of therapy. In the intergroup comparison, the mirror therapy group showed significant improvements compared with the conventional therapy group, both in upper limb function and activities of daily living. [Conclusion] The findings of this study demonstrated that mirror therapy is more effective than conventional therapy for the training of stroke patients to improve their upper limb function and activities of daily living.

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“…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. Mirror therapy involves overlapping the reflection of the movement of the healthy limb with the affected limb, creating in this way an optical illusion.…”

“…Neuroscientist Ramachandran and coworkers introduced the mirror therapy method to treat phantom limb pain in patients with amputations in 1996 (Guo et al, 2016). They were also the first who suggested that this technique might improve the motor function of a paretic limb after stroke (Kim et al, 2016).…”

“…Altschuler and coworkers suggested that mirror therapy provides a visual perception of the normal movement of the affected limb and through this, it might compensate for diminished or lost proprioceptive functions ( Kim et al, 2016). In 1999, mirror therapy was introduced in post-stroke rehabilitation (Guo et al, 2016).…”

Mirror Therapy

“…Besides, it is also proving beneficial for patients suffering unilateral neglect after stroke, in helping relieve phantom limb pain suffered by victims of earthquake as well as to soothe arthritis pain 1,6 . With increase in awareness about the therapy coupled with the boom of online availability of consumer goods, mirror boxes are now also up for sale on the internet and are therefore, more easily available than ever before 9 .…”

“…In each case, amputation was necessary after extensive efforts to save the leg. Before amputation surgery, the patients performed several sessions of mirror therapy 1,4,6 .…”