Background and Aims: The use of visual stimuli to facilitate a desired response in the affected limb in mirror therapy (MT) makes it an effective treatment modality even in instances of a complete plegic upper extremity poststroke. This article analyzes the effects of MT on impairments, activity limitation, and participation restriction in the acute and chronic phases poststroke. Methods: In total, 16 out of 3871 studies were included in the meta-analysis, using PRISMA guidelines. Data were categorized based on application in stroke rehabilitation (acute/chronic, motor/sensory/neglect/activity of daily living, upper limb/lower limb), modes and dosage of intervention delivery, types of control, and outcome assessment. RevMan 5.0 software was used for analysis. Results: Studies were equally distributed between chronic and acute phases. Therapy durations lasted between 1 and 8 weeks. Most studies intervened for upper limb motor impairments showing improvement in Brunnstrom motor recovery stages of arm ( P value: .04, 95% CI, 0.05-1.54, I2 = 59%) and hand ( P value: <.001, 95% CI, 0.80-2.01, I2 = 0%) during acute phase (0-4 weeks). “Activity/function” measured by functional independence measure showed improvement only in self-care subsection ( P value: <.001, 95% CI, 2.05-5.16, I2 = 0%). No long-term effects were analyzed in any of the included studies. Conclusion: A significant finding of this study is the role of MT in improving arm and hand impairments in acute phase poststroke. Rehabilitation protocols can be improved based on this finding. As MT is effective, affordable, and feasible, we have made suggestions toward its incorporation in physiotherapy protocols for low- and middle-income countries.

Sensory dysfunction is one of the common impairments that occurs post stroke. With sensory changes in all modalities, it also affects the quality of life and incites suicidal thoughts. The article attempts to review and describe the current evidence of various approaches of assessment and rehabilitation for post-stroke sensory dysfunction. After extensive electronic database search across Medline, Embase, EBSCO, and Cochrane library, it generated 2433 results. After screening according to inclusion and exclusion criteria, we included 11 studies. We categorized data based on type of sensory deficits and prevalence, role of sensory system on motor behavior, type of intervention, sensory modality targeted, and dosage of intervention and outcome measures used for rehabilitation. Results found the strong evidence of involvement of primary and secondary motor areas involved in processing and responding to somatosensation, respectively. We divided rehabilitation approaches into sensory stimulation approach and sensory retraining approach focused on using external stimuli and relearning, respectively. However, with varied aims and targeted sensory involvement, the study applicability is affected. Thus, this emerges the need of extensive research in future for evidence-based practice of assessments and rehabilitation on post-stroke sensory rehabilitation.

Background & purpose Activity-based neuroplasticity and re-organization leads to motor learning via replicating real-life movements. Increased repetition of such movements has growing evidence over last few decades. In particular, computer-game-based rehabilitation is found to be effective, feasible and acceptable for post-stroke upper limb deficits. Our study aims to evaluate the feasibility and effectiveness of 12 weeks of computer-game-based rehabilitation platform (GRP) on fine and gross motor skills post-stroke in India. Methods Through this trial we will study the effect of adjunctive in-hospital GRP (using a motion-sensing airmouse with off-the-shelf computer games) in 80 persons with subacute stroke, for reduction of post-stroke upper limb deficits in a single-centre prospective Randomized Open, Blinded End- point trial when compared to conventional therapy alone. Results We intend to evaluate between-group differences using Wolf Motor Function test, Stroke Specific Quality of Life, and GRP assessment tool. Feasibility will be assessed via recruitment rates, adherence to intervention periods, drop-out rate and qualitative findings of patient experience with the intervention. Conclusion The CARE FOR U trial is designed to test the feasibility and effectiveness of a computer-game based rehabilitation platform in treating upper limb deficits after stroke. In case of positive findings GRP can be widely applicable for stroke populations needing intensive and regular therapy with supervision.

Background COVID-19 exposed the weakened healthcare sector and burdened the economic sector. Patients with neurological diseases require physical rehabilitation from the acute to chronic phase irrespective of their COVID positive status. Objective To evaluate the qualitative and quantitative changes in neurological physiotherapy at hospital/clinic and home-based settings in India during the COVID-19 pandemic. Methodology Using an online survey, a cross-sectional observational study was implemented among physiotherapists in India who treated neurological patients amidst the pandemic at hospital/clinic and for home-based settings using an online survey. Convenience sampling was used for recruiting participants in the study. Results and Conclusion Most of the physiotherapists, whether working in hospitals or in patients’ homes, indicated a decline in the number of referrals and therapy sessions given to their patients. Both groups resorted to the use of various forms of telerehabilitation in delivering therapy. Even though there is evidence supporting the necessity of physiotherapy for respiratory care, most of the respondents did not put it into practice. No protocols/guidelines for therapy delivery were implemented or used by our sample of respondents. This paper highlights the needs under 3 main categories: (a) development and implementation of contextualized clinical-practice-guidelines and clinical-monitoring systems for neurological physiotherapy, (b) incorporating respiratory physiotherapy sessions supported by research to treat neurological cases in such pandemics, and (c) to modify policies both at public and private domains ensuring incorporation and implementation of physiotherapy for neurological conditions, and to raise campaigns that educate the public on the significance of receiving uninterrupted physiotherapy, even during similar pandemics.