Mirror Therapy Promotes Recovery From Severe Hemiparesis: A Randomized Controlled Trial

Abstract

Background. Rehabilitation of the severely affected paretic arm after stroke represents a major challenge, especially in the presence of sensory impairment. Objective. To evaluate the effect of a therapy that includes use of a mirror to simulate the affected upper extremity with the unaffected upper extremity early after stroke. Methods. Thirty-six patients with severe hemiparesis because of a first-ever ischemic stroke in the territory of the middle cerebral artery were enrolled, no more than 8 weeks after the stroke. They completed a protocol of 6 weeks of additional therapy (30 minutes a day, 5 days a week), with random assignment to either mirror therapy (MT) or an equivalent control therapy (CT). The main outcome measures were the Fugl-Meyer subscores for the upper extremity, evaluated by independent raters through videotape. Patients also underwent functional and neuropsychological testing. Results. In the subgroup of 25 patients with distal plegia at the beginning of the therapy, MT patients regained more distal function than CT patients. Furthermore, across all patients, MT improved recovery of surface sensibility. Neither of these effects depended on the side of the lesioned hemisphere. MT stimulated recovery from hemineglect. Conclusions. MT early after stroke is a promising method to improve sensory and attentional deficits and to support motor recovery in a distal plegic limb.

Efficacy of Upper Limb Therapies for Unilateral Cerebral Palsy: A Meta-analysis

“…64 There is some evidence in adults poststroke that action observation training leads to improved UL motor function. 65,66 The 2 pilot trials of mirror therapy 54 and action observation training 56 in children with unilateral CP showed some preliminary benefits on UL function; however, these approaches should continue to be viewed as experimental until further larger trials can be performed.…”

The efficacy of mirror therapy combined with conventional stroke rehabilitation program on motor and functional recovery

“…Dohle ve ark. 'ın yaptıkları 36 hastayı içeren çalışmada; mesleki tedavi, fizyoterapi ve günlük yaşam akivitelerinden oluşan standart tedaviye ilave edilen ayna tedavisinin Fugl-Meyer motor fonksiyon skalasının parmak motor skorunda anlamlı düzelme sağladığı, günlük yaşam aktivitesindeki düzelmede gruplar arasında farklılığa neden olmadığı bildirilmiştir (23).…”

“…'ın yapmış olduğu bir başka çalışmada ise ayna tedavisi gören hastalarda kol eklem hareket açıklığında ve hareketin hızında artış gösterilmiştir (10). Çalışmamızda ayna grubuna uyguladığımız el bileği ekstansiyon eklem hareket açıklığı egzersizi ile literatürle benzer şekilde Fugl-Meyer el bileği değerlendirme skorunda ve eklem hareket açıklığında artış gözlenmiştir (9,10 Literatürde inme sonrası üst ekstremite rehabilitasyonunda uygulanan ayna tedavisinin uygulanış şekli açısından farkılıklar bulunmaktadır (23,25). Biz, ayna tedavisinin etkinliğini değerlendirmek için izole tek hareket paterni kullanmayı tercih ettik.…”

The impact of visual feedback on the motor control of the upper-limb

“…Mirror Visual Feedback (VF) is one of the recommended strategies to enforce stroke rehabilitation [8], as it is simple, inexpensive and has shown promising results in the rehabilitation of stroke [9,10]. Although a number of authors have investigated the neurological effects of VF [11,12], to our best knowledge the impact of VF in the control structure has not been addressed yet.…”