Neurofunctional changes after a single mirror therapy intervention in chronic ischemic stroke

Novaes, Morgana Menezes; Palhano-Fontes, Fernanda; Peres, André Salles Cunha; Mazzetto-Betti, Kelley C.; Pelicioni, Maristela; Andrade, Kátia C.; Santos, Antônio Carlos dos; Pontes-Neto, Octávio M.; Araújo, Dráulio Barros de

doi:10.1080/00207454.2018.1447571

Cited by 12 publications

(9 citation statements)

References 48 publications

(65 reference statements)

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“…It has been reported that alternative therapies, including neuromuscular electrical stimulation (NMES), acupuncture, and mirror therapy intervention have the potential to facilitate recovery of arm function and also help to prevent the development to the secondary complications. [ 14 – 18 ] Among these interventions, NMES is one of the most widely used therapies. [ 19 – 22 ] In spite of the promising results were reported from the previous studies, insufficient evidence is still available to support that NMES is an efficacious adjunctive therapy for patients with wrist rehabilitation after chronic stroke.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of neuromuscular electrical stimulation for wrist rehabilitation after acute ischemic stroke

2018

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This study investigated the effectiveness of neuromuscular electrical stimulation (NMES) for patients with wrist dysfunction after acute ischemic stroke (AIS).A total of 82 patient cases with wrist dysfunction after AIS were selected in this study. Of these, 41 cases in the intervention group received physical training and NMES treatment. The other 41 cases in the control group received physical training only. The primary outcome was measured by Action Research Arm Test (ARAT) score. The secondary outcomes were measured by the Barthel Index (BI), and numerical rating scale (NRS).After 4-week treatment, patients in the intervention group neither improved arm function recovery, measured by ARAT score (P = .79), and activities of daily living, measured by BI scale (P = .62), nor reduced pain, measured by the NRS scale (P = .11), compared with patients in the control group.The results of this study demonstrated that NMES might not benefit for patients with wrist dysfunction after AIS after 4-week treatment.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of neuromuscular electrical stimulation for wrist rehabilitation after acute ischemic stroke

2018

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“… 27 , 28 ) Further, it reportedly increased excitability of the affected primary motor cortex (M1) in stroke patients after a single 30-min session. 29 ) However, movement of the unaffected hand is required for MVF. Movement of the unaffected hand may increase M1 excitability in the unaffected hemisphere.…”

Section: Discussionmentioning

confidence: 99%

Feasibility Case Study for Treating a Patient with Sensory Ataxia Following a Stroke with Kinesthetic Illusion Induced by Visual Stimulation

Aoyama

Kanazawa

Kohno

et al. 2020

PRM

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Background: Sensory ataxia is a disorder of movement coordination caused by sensory deficits, especially in kinesthetic perception. Visual stimulus-induced kinesthetic illusion (KINVIS) is a method used to provide vivid kinesthetic perception without peripheral sensory input by using a video showing pre-recorded limb movements while the actual limb remains stationary. We examined the effects of KINVIS intervention in a patient with sensory ataxia. Case: The patient was a 59-year-old man with a severe proprioceptive deficit caused by left thalamic hemorrhage. During KINVIS intervention, a computer screen displayed a pre-recorded mirror image video of the patient’s unaffected hand performing flexion–extension movements as if it were attached to the patient’s affected forearm. Kinematics during the flexion–extension movements of the paretic hand were recorded before and after 20-min interventions. Transcranial magnetic stimulation was applied to the affected and non-affected hemispheres. The amplitude of the motor-evoked potential (MEP) at rest was recorded for the muscles of both hands. After the intervention, the total trajectory length and the rectangular area bounding the trajectory of the index fingertip decreased. The MEP amplitude of the paretic hand increased, whereas the MEP amplitude of the non-paretic hand was unchanged. Discussion: The changes in kinematics after the intervention suggested that KINVIS therapy may be a useful new intervention for sensory ataxia, a condition for which few effective treatments are currently available. Studies in larger numbers of patients are needed to clarify the mechanisms underlying this therapeutic effect.

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“…Various clinical trials have demonstrated that MT is an effective treatment for the recovery of the upper extremity in patients who had a subacute stroke. [27][28][29][30][31][32][33][34] Vandana et al 48 evaluated the effects of MT on motor recovery of the upper extremities, spasticity and hand-related functionality of patients who had a subacute stroke and severe hemiparesis (stages II-IV of the Brunnstrom Scale). Moreover, a greater improvement in the scores of the Brunnstrom stages for the hand and upper extremity was observed in the MT group than the conventional therapy group.…”

Section: Discussionmentioning

confidence: 99%

“…6 The observation of normal movements in the mirror provides positive visual feedback and increases the flow of proprioceptive information and activates the neurons and the premotor cortex, thus improving the functionality of the affected upper extremity. [27][28][29] Numerous studies have shown the benefits of MT in the rehabilitation of motor functions of the upper extremity, the performance of ADL and pain thresholds of patients who had a stroke. [27][28][29][30][31][32][33][34] However, Oliveira-Castro et al 35 did not observe considerable improvements in self-care because of different limitations such as the short duration of the programme, small sample size and lack of randomisation.…”

Section: Mirror Therapymentioning

confidence: 99%

“…6 Therefore, the majority of studies have agreed on the need for further research in this area. [27][28][29][30][31][32][33][34][35] Cognitive therapeutic exercise The objective of CTE or the Perfetti method, a cognitive rehabilitation modality, is to achieve motor functions using afferent information of a proprioceptive and/or tactile type. The proprioceptive information received is associated with the recognition of the direction, distance and shapes through the body.…”

Section: Mirror Therapymentioning

confidence: 99%

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Effects of home-based mirror therapy and cognitive therapeutic exercise on the improvement of the upper extremity functions in patients with severe hemiparesis after a stroke: a protocol for a pilot randomised clinical trial

et al. 2020

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IntroductionNeuroplasticity is defined as the capacity of the brain to reorganise new neuronal pathways. Mirror therapy (MT) and cognitive therapeutic exercise (CTE) are two neurorehabilitation techniques based on neuroplasticity and designed to improve the motor functions of the affected upper extremity in patients with severe hemiparesis after a stroke. Home-based interventions are an appropriate alternative to promote independence and autonomy. The objective of this study is to evaluate which of these techniques, MT and CTE, combined with task-oriented training, is more effective in functional recovery and movement patterns of the upper extremities in patients with severe hemiparesis after a stroke.Methods and analysisThis is a home-based, single-blind, controlled, randomised clinical trial with three parallel arms, including 154 patients who had a stroke aged above 18 years. The primary outcome will be the functionality of the affected upper extremity measured using the Fugl-Meyer Assessment. Secondary variables will include cognitive performance, emotional state, quality of life and activities of daily living. During 6 weeks, one of the intervention groups will receive a treatment based on MT and the other one on CTE, both combined with task-oriented training. No additional interventions will be provided to the control group. To assess the progress of patients who had a stroke in the subacute phase, all variables will be evaluated at different visits: initial (just before starting treatment and 4 weeks post-stroke), post-intervention (6 weeks after initial) and follow-up (6 months).Ethics and disseminationThis protocol has been approved by the Institutional Review Board (CEIm-2.134/2.019) and registered at ClinicalTrials.gov (NCT04163666). The results will be disseminated through open-access peer-reviewed journals, conference presentation, broadcast media and a presentation to stakeholders. These study results will provide relevant and novel information on effective neurorehabilitation strategies and improve the quality of intervention programmes aimed at patients after a stroke.Trial registration numberClinicalTrials.gov (NCT04163666).

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Neurofunctional changes after a single mirror therapy intervention in chronic ischemic stroke

Abstract: Our study suggests that a single MT intervention in stroke survivors is related to increased MEP of the affected limb, and a more constrained activity of the affected M1, as if activity had become more constrained and limited to the affected hemisphere.

Cited by 12 publications

References 48 publications

Effectiveness of neuromuscular electrical stimulation for wrist rehabilitation after acute ischemic stroke

Effectiveness of neuromuscular electrical stimulation for wrist rehabilitation after acute ischemic stroke

Feasibility Case Study for Treating a Patient with Sensory Ataxia Following a Stroke with Kinesthetic Illusion Induced by Visual Stimulation

Effects of home-based mirror therapy and cognitive therapeutic exercise on the improvement of the upper extremity functions in patients with severe hemiparesis after a stroke: a protocol for a pilot randomised clinical trial

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