Task-Based Mirror Therapy Augmenting Motor Recovery in Poststroke Hemiparesis: A Randomized Controlled Trial

Arya, Kapil; Pandian, Shanta; Kumar, Dharmendra; Puri, Vinod

doi:10.1016/j.jstrokecerebrovasdis.2015.03.026

Cited by 64 publications

(69 citation statements)

References 48 publications

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“…Arya et al [22] compared a group of patients who underwent functional tasks and mirror therapy with a group that received conventional treatment. The former group showed a more significant improvement in Fugl-Meyer Assessment and Brunnstrom stage.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients

et al. 2016

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ObjectiveTo investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke.MethodsThe subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment.ResultsThe upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group.ConclusionIn this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients

et al. 2016

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“…Upper extremity complications are common following stroke and may be seriously debilitating, causing the stroke patient to experience difficulties with activities of daily living (1,2). To support and improve quality of life in stroke patients, various motor-assistance devices and new treatment methods have been developed to restore motor functioning in stroke patients (3)(4)(5). In particular, various treatment methods for upper extremity rehabilitation have emerged; these include virtual reality, robot-arm training, mental practice, and mirror therapy (MT) (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke

Chang

Chen

et al. 2019

Front. Neurol.

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Mirror therapy (MT) facilitates motor learning and induces cortical reorganization and motor recovery from stroke. We applied the new digital mirror therapy (DMT) system to compare the cortical activation under the three visual feedback conditions: (1) no mirror visual feedback (NoMVF), (2) bilateral synchronized task-based mirror visual feedback training (BMVF), and (3) reciprocal task-based mirror visual feedback training (RMVF). During DMT, EEG recordings, including time-dependent event-related desynchronization (ERD) signal amplitude in both mu and beta bands, were obtained from the standard C3 (ispilesional hemisphere, IH), C4 (contralesional hemisphere, CH), and Cz scalp sites (supplementary motor area, SMA). The entire ERD curve was separated into three time-phases: P0 (−2 to 0 s), P1 (0 to 2 s), and P2 (2 to 4 s). Four-way and subsequent repeated-measures analyses of variance were used to examine the effects of group (stroke vs. control group), test condition (NoMVF, BMVF, and RMVF), time-phase (P0, P1, and P2), and brain area (IH, CH, SMA) on the ERD areas (%) in mu and beta bands. For the mu band, generally, ERD areas (%) were larger in the control than in the stroke group. The ERD areas (%) were largest under the RMVF condition, followed by BMVF and NoMVF conditions. Similar results were found in the beta bands. The main effects of group, time-phase, and test condition on the ERD areas (%) were significant for the three brain areas, except the main effect of group in the SMA (Cz) and CH (C4) brain area. The ERD areas (%) were larger in the control than in the stroke group. The ERD area (%) was significantly larger during P1 than during P0 and P2 (ps < 0.02), and during P2 than during P0 (ps < 0.01). The ERD area (%) under the RMVF condition was significantly larger than that under the BMVF condition and NoMVF condition (ps < 0.05). The present study suggests that cortical activation particularly in the SMA (Cz) of the brain increases in the RMVF condition in both healthy subjects and stroke patients. This result supports the hypothesis that stroke patients may benefit from RMVF training.

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“…Evidence from neuroimaging suggests that the brain network involved in MVF is considerably overlapped with two fronto-parietal networks known to be more responsive to target-directed actions: the network for spatial attention (Michielsen et al, 2011b; Mehnert et al, 2013; Wang et al, 2013a,b) and the action observation network (AON; Rosén and Lundborg, 2005; Sütbeyaz et al, 2007; Matthys et al, 2009; Ramachandran and Altschuler, 2009; Hamzei et al, 2012; Nojima et al, 2012; Howatson et al, 2013). It is therefore plausible, that MVF combined with a task that requires movements to be performed toward a visually defined target, may have advantages over a paradigm that does not involve an explicit visual target (e.g., see discussion in Arya and Pandian, 2013; Arya et al, 2015). This has never been explicitly tested, but such a finding could help reconcile the discrepancy noted in the MVF literature and advance our understanding of how to best administer MVF.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Mirror Feedback during Target Directed Movements on Ipsilateral Corticospinal Excitability

Yarossi

Manuweera

Adamovich

et al. 2017

Front. Hum. Neurosci.

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Mirror visual feedback (MVF) training is a promising technique to promote activation in the lesioned hemisphere following stroke, and aid recovery. However, current outcomes of MVF training are mixed, in part, due to variability in the task undertaken during MVF. The present study investigated the hypothesis that movements directed toward visual targets may enhance MVF modulation of motor cortex (M1) excitability ipsilateral to the trained hand compared to movements without visual targets. Ten healthy subjects participated in a 2 × 2 factorial design in which feedback (veridical, mirror) and presence of a visual target (target present, target absent) for a right index-finger flexion task were systematically manipulated in a virtual environment. To measure M1 excitability, transcranial magnetic stimulation (TMS) was applied to the hemisphere ipsilateral to the trained hand to elicit motor evoked potentials (MEPs) in the untrained first dorsal interosseous (FDI) and abductor digiti minimi (ADM) muscles at rest prior to and following each of four 2-min blocks of 30 movements (B1–B4). Targeted movement kinematics without visual feedback was measured before and after training to assess learning and transfer. FDI MEPs were decreased in B1 and B2 when movements were made with veridical feedback and visual targets were absent. FDI MEPs were decreased in B2 and B3 when movements were made with mirror feedback and visual targets were absent. FDI MEPs were increased in B3 when movements were made with mirror feedback and visual targets were present. Significant MEP changes were not present for the uninvolved ADM, suggesting a task-specific effect. Analysis of kinematics revealed learning occurred in visual target-directed conditions, but transfer was not sensitive to mirror feedback. Results are discussed with respect to current theoretical mechanisms underlying MVF-induced changes in ipsilateral excitability.

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Task-Based Mirror Therapy Augmenting Motor Recovery in Poststroke Hemiparesis: A Randomized Controlled Trial

Cited by 64 publications

References 48 publications

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients

Alternative Motor Task-Based Pattern Training With a Digital Mirror Therapy System Enhances Sensorimotor Signal Rhythms Post-stroke

The Effects of Mirror Feedback during Target Directed Movements on Ipsilateral Corticospinal Excitability

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