Mirror therapy for improving motor function after stroke

Thieme, Holm; Mehrholz, Jan; Pohl, Marcus; Dohle, Christian

doi:10.1002/14651858.cd008449

Cited by 18 publications

(12 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies of adults poststroke have shown improved UL motor function and reduced pain after mirror therapy. 63 Action observation training involves watching a motor action performed by another person, followed by execution of that motor action, and is believed to tap into the mirror neuron system. 64 There is some evidence in adults poststroke that action observation training leads to improved UL motor function.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Upper Limb Therapies for Unilateral Cerebral Palsy: A Meta-analysis

2014

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Children with unilateral cerebral palsy present with impaired upper limb (UL) function affecting independence, participation, and quality of life and require effective rehabilitation. This study aims to systematically review the efficacy of nonsurgical upper limb therapies for children with unilateral cerebral palsy. METHODS: Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, the Cochrane Central Register of Controlled Trials, and PubMed were searched to December 2012. Randomized controlled or comparison trials were included. RESULTS: Forty-two studies evaluating 113 UL therapy approaches (N = 1454 subjects) met the inclusion criteria. Moderate to strong effects favoring intramuscular injections of botulinum toxin A and occupational therapy (OT) to improve UL and individualized outcomes compared with OT alone were identified. Constraint-induced movement therapy achieved modest to strong treatment effects on improving movement quality and efficiency of the impaired UL compared with usual care. There were weak treatment effects for most outcomes when constraint therapy was compared with an equal dose (amount) of bimanual OT; both yielded similar improved outcomes. Newer interventions such as action observation training and mirror therapy should be viewed as experimental. CONCLUSIONS: There is modest evidence that intensive activity-based, goal-directed interventions (eg, constraint-induced movement therapy, bimanual training) are more effective than standard care in improving UL and individualized outcomes. There is little evidence to support block therapy alone as the dose of intervention is unlikely to be sufficient to lead to sustained changes in UL outcomes. There is strong evidence that goal-directed OT home programs are effective and could supplement hands-on direct therapy to achieve increased dose of intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of Upper Limb Therapies for Unilateral Cerebral Palsy: A Meta-analysis

2014

View full text Add to dashboard Cite

show abstract

“…Mirror training is used in the treatment of chronic pain conditions (Bowering et al 2013) and to improve motor function after stroke (Thieme et al 2012). Somewhat surprisingly, recent work without a mirror showed that strength training of the unaffected limb is beneficial for the recovery of the impaired limb after stroke (Clark and Patten 2013;Dragert andZehr 2011, 2013), wrist fractures (Magnus et al 2013), and anterior cruciate ligament reconstructive surgery (Papandreou et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Mirror illusion reduces motor cortical inhibition in the ipsilateral primary motor cortex during forceful unilateral muscle contractions

Zult

Goodall

Thomas

et al. 2015

Journal of Neurophysiology

View full text Add to dashboard Cite

Forceful, unilateral contractions modulate corticomotor paths targeting the resting, contralateral hand. However, it is unknown whether mirror-viewing of a slowly moving but forcefully contracting hand would additionally affect these paths. Here we examined corticospinal excitability and short-interval intracortical inhibition (SICI) of the right-ipsilateral primary motor cortex (M1) in healthy young adults under no-mirror and mirror conditions at rest and during right wrist flexion at 60% maximal voluntary contraction (MVC). During the no-mirror conditions neither hand was visible, whereas in the mirror conditions participants looked at the right hand's reflection in the mirror. Corticospinal excitability increased during contractions in the left flexor carpi radialis (FCR) (contraction 0.41 mV vs. rest 0.21 mV) and extensor carpi radialis (ECR) (contraction 0.56 mV vs. rest 0.39 mV), but there was no mirror effect (FCR: P ϭ 0.743, p 2 ϭ 0.005; ECR: P ϭ 0.712, p 2 ϭ 0.005). However, mirror-viewing of the contracting and moving wrist attenuated SICI relative to test pulse in the left FCR by ϳ9% compared with the other conditions (P Ͻ 0.05, d Ն 0.62). Electromyographic activity in the resting left hand prior to stimulation was not affected by the mirror (FCR: P ϭ 0.255, p 2 ϭ 0.049; ECR: P ϭ 0.343, p 2 ϭ 0.035) but increased twofold during contractions. Thus viewing the moving hand in the mirror and not just the mirror image of the nonmoving hand seems to affect motor cortical inhibitory networks in the M1 associated with the mirror image. Future studies should determine whether the use of a mirror could increase interlimb transfer produced by cross-education, especially in patient groups with unilateral orthopedic and neurological conditions.

show abstract

“…Research demonstrates the need for continual growth for this type of therapy based on the observed benefits. Improvements such as enhanced fluidity of movement patterns, ability to carry out daily activities, pain reduction, improved grasp, and maintenance were demonstrated to extend beyond 6 mo of treatment [17][18][19][20]. Another recent study using mirror therapy, published by Lee et al in 2012, noted improvements in Fugl-Meyer Assessment scores for shoulder, elbow, and hand, as well as improvement in the Manual Function Test scores for shoulder and hand items [21].…”

Section: Mirror Therapymentioning

confidence: 98%

Pilot study: Computer-based virtual anatomical interactivity for rehabilitation of individuals with chronic acquired brain injury

Simmons

Arthanat²,

Macri

2014

J Rehabil Res Dev

View full text Add to dashboard Cite

Abstract-Deficiencies in upper-limb motor function and executive functioning can compromise an affected individual's ability to complete everyday activities. Impaired motor and executive functioning therefore pose a risk to increasing numbers of veterans who have been diagnosed with acquired brain injury. This article reports on changes in upper-limb motor function and executive functioning of 12 adult participants with chronic acquired brain injury using a novel, computer-based, motor and cognitive rehabilitation program called PreMotor Exercise Games (PEGs). Manual muscle, goniometric range of motion, and dynamometer assessments were used to determine motor functioning while the Executive Function Performance Test measured cognitive functioning. A three-level repeated measures design was conducted to determine changes pre-and postintervention. Participants demonstrated significant improvement in shoulder (p = 0.01) and wrist (p = 0.01) range of motion and clinically relevant improvement for elbow range of motion. Participants demonstrated clinically relevant improvement in shoulder, elbow, and wrist strength. Finally, participants demonstrated significant improvement in executive functioning (p < 0.05). Using PEGs as a modality for both motor and cognitive intervention is a potentially beneficial adjunct to rehabilitation and warrants further study.

show abstract

Mirror therapy for improving motor function after stroke

Cited by 18 publications

References 33 publications

Efficacy of Upper Limb Therapies for Unilateral Cerebral Palsy: A Meta-analysis

Efficacy of Upper Limb Therapies for Unilateral Cerebral Palsy: A Meta-analysis

Mirror illusion reduces motor cortical inhibition in the ipsilateral primary motor cortex during forceful unilateral muscle contractions

Pilot study: Computer-based virtual anatomical interactivity for rehabilitation of individuals with chronic acquired brain injury

Contact Info

Product

Resources

About