Task-based mirror therapy enhances the upper limb motor function in subacute stroke patients: a randomized control trial

Madhoun, Hamza Yassin; Tan, Botao; Feng, Yali; Zhou, Yi; Zhou, Cuijuan; Yu, Lehua

doi:10.23736/s1973-9087.20.06070-0

Cited by 39 publications

(34 citation statements)

References 26 publications

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“…Moreover, the device can dynamically match the motion trajectory of the RAT with the motion images displayed in real time by the VRMT, so as to realize the cycle of "visual information input-visual information output-motion feedback" in the stroke patient. This is different from other combinations of a central intervention and a peripheral intervention for upper limb motor dysfunction after stroke [21,22], which a central intervention and a peripheral intervention do not dynamically match each other in real time. In summary, the device is an innovative medical rehabilitation machine, which realizes the cycle of "visual information input-visual information output-motion feedback", and provides patients with a full-body immersive experience that is consistent with vision, touch, and proprioception.…”

Section: Introductionmentioning

confidence: 68%

Effectiveness of robot-assisted virtual reality mirror therapy for upper limb motor dysfunction after stroke: study protocol for a single-center randomized controlled clinical trial

et al. 2022

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Background Upper limb motor dysfunction is a common sequela of stroke, and its clinical efficacy needs to be improved. This protocol describes a trial to verify the clinical efficacy of robot-assisted virtual reality mirror therapy (RAVRMT) in improving upper limb motor dysfunction in stroke patients, and to explore the central mechanism by using functional magnetic resonance imaging (fMRI). Methods This trial will be a single-center, assessor-blinded, randomized controlled clinical study. Thirty-two eligible patients will be randomly divided into 2 groups according to the ratio of 1:1, namely virtual reality mirror therapy (VRMT) group and robot-assisted virtual reality mirror therapy (RAVRMT) group. The interventions will be performed once a day for 4 weeks. Primary outcome is Fugl–Meyer motor function assessment-Upper Extremity (FMA-UE), secondary outcomes are the Montreal Cognitive Assessment (MoCA), activities of daily living (ADL), quality of life (QOL), the pain visual analogue scale (VAS-pain) and fMRI. Adverse events will be recorded, and severe adverse events will be used as criteria to discontinue the intervention. Discussion Combined application of robot-assisted therapy and virtual reality mirror therapy could theoretically activate mirror neuron system and reward circuits to a greater extent, but further high-quality research is needed. The results of this trial will determine whether RAVRMT could better improve upper limb motor dysfunction after stroke and explore its central mechanism using fMRI. Trial registration This trial was prospectively registered at ClinicalTrials.gov (ChiCTR2200061721; 01 July 2022).

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Section: Introductionmentioning

confidence: 68%

Effectiveness of robot-assisted virtual reality mirror therapy for upper limb motor dysfunction after stroke: study protocol for a single-center randomized controlled clinical trial

et al. 2022

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“…As concerned about future progress of our VR rehabilitation system, the implementation of the mirror modality (see Methods section for details) can extend and increase the therapeutic applications in terms of patients’ subgroups and rehabilitative goals. The use of mirror therapy has shown clinical benefits in post-stroke patients in the improvement of upper limb motor function and impairment (Thieme et al, 2018), particularly for severely impaired ones (Colomer et al, 2016; Madhoun et al, 2020). This therapeutic intervention has proven to be instrumental also for pain reduction in patients affected by Complex Regional Pain Syndrome type 1 (Cacchio et al, 2009; Pervane Vural et al, 2016), a frequent and debilitating post-stroke condition that compromises rehabilitative outcomes.…”

Section: Discussionmentioning

confidence: 99%

A novel immersive virtual reality environment for the motor rehabilitation of stroke patients: A feasibility study

Fregna

Schincaglia

Baroni

et al. 2022

Preprint

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We designed and implemented an immersive virtual reality environment for upper limb rehabilitation, which possesses several notable features. First, by exploiting modern computer graphics its can present a variety of scenarios that make the rehabilitation routines challenging yet enjoyable for patients, thus enhancing their adherence to the therapy. Second, immersion in a virtual 3D space allows the patients to execute tasks that are closely related to everyday gestures, thus enhancing the transfer of the acquired motor skills to real-life routines. Third, in addition to the VR environment, we also developed a client app running on a PC that allows to monitor in real-time and remotely the patients’ routines thus opening the door to telerehabilitation scenarios.Here, we report the results of a feasibility study in a cohort of 16 stroke patients. All our patients showed a high degree of comfort in our immersive VR system and they reported very high scores of ownership and agency in embodiment and satisfaction questionnaires. Furthermore, and notably, we found that behavioral performances in our VR tasks correlated with the patients’ clinical scores (Fugl-Meyer scale) and they can thus be used to assess improvements during the rehabilitation program. While further studies are needed, our results clearly support the feasibility and effectiveness of VR-based motor rehabilitation processes.Significance statementApproximately 80% of stroke patients suffer from a hemiparesis of the contralateral upper limb. Motor rehabilitation has been proven to be of key importance to regain, partially or totally, the impaired motor skills. Rehabilitation techniques are based on the repetitive and intense execution of simple motor behaviors. As such they can become taxing and cumbersome for the patients. This often produces non-adherence issues with an obvious negative impact on motor recovery.Here we describe a novel immersive virtual environment for upper limb motor rehabilitation and we report the results that we obtained in a cohort of 16 stroke patients. Our system was designed to turn rehabilitation routines into engaging games and to allow the remote monitoring of the patients’ exercises thus allowing telerehabilitation.All our patients showed a high degree of comfort in our immersive VR system and they reported very high scores of ownership and agency in embodiment and satisfaction questionnaires. Furthermore, and notably, we found that behavioral performances in our VR tasks correlated with the patients’ clinical scores (Fugl-Meyer scale) and they can thus be used to assess improvements during the rehabilitation program.

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“…Additionally, therapeutic training using mirrors presents an intervention method that can be easily applied in clinical practice, helping patients improve their motor functions firsthand. A previous study reported that, when exercise therapy and observation were applied to stroke patients along with the use of a mirror, visual feedback to restore functions was facilitated, and that the stimulation of observing non-paretic-side movements facilitated stroke patients' recovery while reducing the temporal and spatial neglect that can occur after a stroke (Madhoun et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

A study of therapeutic intervention methods to improve proprioception among hemiplegic stroke patients

Lee¹

2022

Int. j. adv. appl. sci.

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The present study uses proprioceptive neuromuscular stimulation (which can increase nerve plasticity by stimulating proprioception) and modified mirror therapy to provide feedback in order to investigate these treatments’ effects on upper-limb functions and daily living activities among stroke patients. The experimental group (n=15) underwent a mirror therapy program after PNF for 30 minutes three times weekly, for a total of 18 treatment sessions. Meanwhile, the control group (n=15) underwent only PNF treatment three times weekly for a total of 18 treatment sessions. Evaluations of participants’ paretic upper-limb functions and ability, as well as their daily living activities, were conducted using the Fugl-Meyer assessment scale (FMA), manual function test (MFT), motor activity log (MAL), and functional independence measure (FIM). The FMA, MFT, MAL, and FIM scores of the experimental group differed statistically significantly from those of the control group in terms of curative effects. Thus, the results of this study show that PNF and mirror therapy are effective interventions to improve upper-limb functions and activities, as well as the performance of daily living activities, among hemiplegic stroke patients.

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Task-based mirror therapy enhances the upper limb motor function in subacute stroke patients: a randomized control trial

Cited by 39 publications

References 26 publications

Effectiveness of robot-assisted virtual reality mirror therapy for upper limb motor dysfunction after stroke: study protocol for a single-center randomized controlled clinical trial

Effectiveness of robot-assisted virtual reality mirror therapy for upper limb motor dysfunction after stroke: study protocol for a single-center randomized controlled clinical trial

A novel immersive virtual reality environment for the motor rehabilitation of stroke patients: A feasibility study

A study of therapeutic intervention methods to improve proprioception among hemiplegic stroke patients

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