Mirror therapy enhances upper extremity motor recovery in stroke patients

Abstract

The purpose of this study was to evaluate the effects of mirror therapy program in addition with physical therapy methods on upper limb recovery in patients with subacute ischemic stroke. 15 subjects followed a comprehensive rehabilitative treatment, 8 subjects received only control therapy (CT) and 7 subjects received mirror therapy (MT) for 30 min every day, five times a week, for 6 weeks in addition to the conventional therapy. Brunnstrom stages, Fugl-Meyer Assessment (upper extremity), the Ashworth Scale, and Bhakta Test (finger flexion scale) were used to assess changes in upper limb motor recovery and motor function after intervention. After 6 weeks of treatment, patients in both groups showed significant improvements in the variables measured. Patients who received MT showed greater improvements compared to the CT group. The MT treatment results included: improvement of motor functions, manual skills and activities of daily living. The best results were obtained when the treatment was started soon after the stroke. MT is an easy and low-cost method to improve motor recovery of the upper limb.

Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors

“…Eight studies reported intergroup differences after the intervention, with values of Cohen's d as follows: 1.70 (Park et al ., ), 1.12 (Samuelkamaleshkumar et al ., ), 1.00 1.35 (Kim et al ., ), 0.98 (Arya et al ., ), 0.76 (Kojima et al ., ), 0.58–0.76 (Lee, Cho et al ., ), 0.49 (Michielsen et al ., ), 0.37 (Wu et al ., ) and 0.28–0.38 (Lin et al ., ). In addition, in five studies there was a post‐intervention improvement in function in the intervention group, with values of Cohen's d as follows: 1.55 (Mirela Cristina et al ., ), 1.15 (Samuelkamaleshkumar et al .), 1.15–1.87 (Lee, Cho et al ., 2012), 1.00–1.35 (Kim et al ., ) and 0.19–0.72 (Lee, Lee et al ., ).…”

“…Motor recovery of hemiplegic arms and hands was analysed in five studies (Arya et al ., ; Kim et al ., ; Lee, Cho et al ., 2012; Mirela Cristina et al ., ; Samuelkamaleshkumar et al ., ). Four studies reported a post‐intervention improvement in motor performance in the MT group (Kim et al ., ; Lee, Cho et al ., 2012; Mirela Cristina et al ., ; Samuelkamaleshkumar et al .), values of Cohen's d ranged between 1.27 and 1.38 (Kim et al ., ).…”

“…There were clinically relevant (>10%) intragroup differences in recovery of upper limb, upper limb function and gross manual dexterity (Escobar, Quintana, Bilbao, Azkárate, & Güenaga, ; Keller, Hayden, Bombardier, & van Tulder, ), so these variables were categorised as primary variables. Intragroup comparisons were carried out for 52 variables and differences were detected with respect to 46 variables across eight studies (Cacchio et al .; Invernizzi et al .; Kim et al ., ; Kojima et al .; Lee, Lee et al ., ; Lee, Cho et al ., 2012; Mirela Cristina et al ., ; Samuelkamaleshkumar et al .).…”

“…Within the intervention group, five studies present a post‐intervention improvement in function, with values of Cohen's d ranging from 0.19 (Lee et al ., ) to 1.87 (Lee, Cho et al ., 2012). In four of these studies, MT had a large effect ( d ≥ 0.8) (Rice & Harris, ) in the intervention group (Kim et al ., ; Lee, Cho et al ., 2012; Mirela Cristina et al ., ; Samuelkamaleshkumar et al ., ), while there was a small to moderate effect (small: d ≥ 0.20; moderate: d ≥ 0.5) (Rice & Harris, ) in the study by Lee et al . ().…”

“…Using longer MT sessions appears to reduce the effectiveness of the intervention in improving motor recovery of the upper limb; the improvement observed with 90‐minute sessions (Lee, Lee et al ., ) was less than that observed when MT sessions were 25–30 minutes long (Kim et al ., ; Lee, Cho et al ., 2012; Mirela Cristina et al ., ; Samuelkamaleshkumar et al ., ). Improvement in control groups which received CR ranged from 0.4 (Lee, Cho et al ., 2012) to 8.7 points (Mirela Cristina et al ., ) in the scale used to asses this variable (see Table ) (Kim et al ., ; Kojima et al ., ; Lee, Lee et al ., ; Lee, Cho et al ., 2012; Mirela Cristina et al ., ; Samuelkamaleshkumar et al .).…”