The Efficacy of Lower Extremity Mirror Therapy for Improving Balance, Gait, and Motor Function Poststroke: A Systematic Review and Meta-Analysis

Louie, Dennis R.; Lim, Shannon B.; Eng, Janice J.

doi:10.1016/j.jstrokecerebrovasdis.2018.09.017

Cited by 40 publications

(48 citation statements)

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“…Used to support and maintain the proper functioning of the nervous system. [81] NIBS for hemispatial neglect 10/226 NIBS combined with other therapies has positive effect on hemispatial neglect and performance in ADL (moderatequality evidence) Both excitatory and inhibitory stimulations are effective. [82] NIBS for gait speed 10/226 NIBS combined with other therapies are effective to improve gait speed (moderate-quality evidence) [83] NIBS for paretic limb force production 23 Improvements in paretic limb force after tDCS and rTMS Positive effects on force production by increasing cortical activity in the ipsilesional hemisphere and decreasing cortical activity in the contralesional hemisphere.…”

Section: Inosinementioning

confidence: 99%

“…The last Cochrane review indicates that mirror therapy may be effective for improving motor function, activities of daily living and pain relieve [80,112]. Mirror therapy is most often used in upper limb rehabilitation, but may also have a beneficial effect used for improving function in which lower limb are engaged, like gait speed [81].…”

Section: Mirror Therapymentioning

confidence: 99%

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Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery

Szelenberger

Kostka

Saluk‐Bijak

et al. 2019

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Neuroplasticity is a natural process occurring in the brain for the entire life. Stroke is the leading cause of long term disability and a huge medical and financial problem throughout the world. Research conducted over the past decade focused mainly on neuroprotection in the acute phase of stroke while very little studies target the chronic stage. Recovery after stroke depends on the ability of our brain to reestablish the structural and functional organization of neurovascular networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore impaired brain functions. Currently, there are some drugs and rehabilitative strategies that can facilitate brain repair and improve clinical effect even years after stroke onset. Moreover, some of the compounds such as citicoline, fluoxetine, niacin, levodopa, etc. are already in clinical use or are being trialed in clinical issues. Many studies are also testing cell therapies; in our review, we focused on studies where cells have been implemented at the early stage of stroke. Next, we discuss pharmaceutical interventions. In this section, we selected methods of cognitive, behavioral, and physical rehabilitation as well as adjuvant interventions for neuroprotection including noninvasive brain stimulation and extremely low-frequency electromagnetic field. The modern rehabilitation represents a new model of physical interventions with the limited therapeutic window up to six months after stroke. However, previous studies suggest that the time window for stroke recovery is much longer than previously thought. This review attempts to present the progress in neuroprotective strategies, both pharmacological and non-pharmacological that can stimulate the endogenous neuroplasticity in post-stroke patients.

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Section: Inosinementioning

confidence: 99%

Section: Mirror Therapymentioning

confidence: 99%

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery

Szelenberger

Kostka

Saluk‐Bijak

et al. 2019

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“…[1,14] Many attempts have been done to predict gait recovery of stroke patients, but among all, time since stroke onset towards rehabilitation initiation had shown weak positive response. [15,16] Topographical identification of stroke lesion though weakly, had also shown relationship to walking parameters. It was shown that non-corticospinal tract lesions (putamen and neighboring structures) could affect walking speed, whereas when corticospinal tract is affected, it will then impact everyday functions of general mobility and gait.…”

Section: Introductionmentioning

confidence: 99%

“…[16] There are various measurement scales that are used to assess post stroke motoric scores, however studies had shown that Brunnstrom's motor recovery grading has been widely used to assess the presence of synergy patterns, which is 1 component of motoric recovery. [15] The recovery grading then uses a 7 point hierarchy scale, in which stage 1 appears after stroke onset, that is flaccid stage, stage 2 up to 4 shows the development of spasticity synergy, stage 5 is where voluntary movement starts to dominate the synergy, and finally stage 6 shows how spasticity is no longer present, coordination and voluntary movements are near normal. [17,18] In the original published definition, the stage 7 of Brunnstrom's stage shows the presence of age appropriate normal variety of complex movement patterns, and there is no evidence of functional impairment when compared to the non-paretic limb.…”

Section: Introductionmentioning

confidence: 99%

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Gait turning patterns in chronic ischemic stroke males and its relationship to recovery

Kusumaningsih¹,

Triangto²,

Harris

2019

Medicine

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Introduction:Impaired turning patterns have been considered as 1 factor which potentially leads to disability in chronic stroke patients. Mobility comprises 80% of the chief disability, and would eventually lead to falls. Expanded Timed Up and Go (ETUG) is an effective mobility assessment method. It utilizes video recording to analyze the conventional Time Up and Go (TUG) Test components, which includes turning pattern analysis.Methods:Six healthy males without stroke history and 21 chronic ischemic stroke males (divided into subjects with or without the presence of flexor synergy pattern subgroups) capable of independent ambulation were recruited from Neurology and Medical Rehabilitation Department outpatient clinic. ETUG tests were recorded for each subject and were analyzed thoroughly using a computer program.Results:Timed Up and Go time was significantly different between the 3 groups (P = .001). As compared to control, and synergy absent group, median turning time was highest in chronic stroke patients with presence of flexor synergy by 2786 ms (P = .002), but was not significantly different in percentage ETUG (14%, P = .939). Further analysis revealed that Brunnstrom stage and number of steps taken for turning significantly affect TUG duration. Other factors such as hemiparetic side, or body height were not significantly associated.Discussion:The presence of flexor synergy would significantly affect turning time, this would then correlate to the disability of shifting body's center of gravity, as a part of the Stroke core set of International Classification of Functioning, Disability, and Health (ICF).Therefore, stroke patients need to have early ambulatory training regarding pivoting motion rather than solely focusing on straight walking. Instead of hemiparetic side, it is possible that overall turning time is affected by coordination and orientation capability, signifying the importance of cortical plasticity.

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Effects of mirror therapy on spasticity and sensory impairment after stroke: Systematic review and meta‐analysis

Muñoz-Gómez

Inglés

Aguilar‐Rodríguez

et al. 2023

PM&R

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ObjectiveTo review and synthesize existing evidence on the effectiveness of mirror therapy (MT) compared to active exercise‐based interventions (ie, cross‐training and conventional exercise) for reducing spasticity and sensory impairment in stroke survivors.TypeSystematic Review and Metanalysis.Literature SurveyPubmed/MEDLINE, Cochrane, Embase, CINAHL, and Physiotherapy Evidence Database (PEDro), were searched.MethodologyRandomized controlled trials (RCTs) that investigated MT effectiveness in improving spasticity and sensory impairment in stroke survivors compared to a control group.SynthesisFifteen RCTs (653 volunteers) were included. Spasticity improvements achieved with MT were similar to those obtained with cross‐training (standard mean difference [SMD]: 0.12, 95% confidence interval [CI]: −0.43 to 0.68). In addition, when further combined with conventional exercise, spasticity improved similarly in both groups (SMD: 0.10, 95% CI: −0.16, 0.36). Lastly, when MT plus exercise was compared to exercise alone, spasticity decreased in both groups (SMD: 0.16, 95% CI: −0.16 to 0.48). Nevertheless, none of the Interventions seem effective on sensory impairment (SMD: 0.27, 95% CI: −0.28 to 0.81).ConclusionsMT is equally effective as other exercise therapies, such as cross‐training and conventional exercise, for improving spasticity in stroke survivors, whereas none of the explored interventions yielded beneficial effects on sensory impairment. Further well‐designed RCTs are needed to confirm the results.

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The Efficacy of Lower Extremity Mirror Therapy for Improving Balance, Gait, and Motor Function Poststroke: A Systematic Review and Meta-Analysis

Cited by 40 publications

References 40 publications

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery

Gait turning patterns in chronic ischemic stroke males and its relationship to recovery

Effects of mirror therapy on spasticity and sensory impairment after stroke: Systematic review and meta‐analysis

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