Systematic review of the effects of mirror therapy in children with cerebral palsy

Abstract

[Purpose] To provide data for systematic intervention plans in occupational therapy practice by objectivity showing the value of mirror therapy interventions in children with cerebral palsy. [Subjects and Methods] Medline and EMBASE databases were searched for the key words “cerebral palsy,” “mirror movement,” “mirror therapy,” and “mirror visual feedback.” Nine studies that met the inclusion and exclusion criteria were identified. The qualitatively determined level of evidence, period of research, comparisons and interventions, tools used to measure the intervention, and the effects were analyzed. [Results] According to the results analyzed, one (1/9, 11.1%) study showed the same result as the control group, one (1/9, 11.1%) showed a negative effect, and seven (7/9, 77.8%) showed positive effects of mirror-mediated therapy, with meaningful improvement in function, such as hand strength, movement speed, muscle activity, and accuracy of hand matching. [Conclusion] Through this study, the value of mirror-mediated therapeutic interventions in occupational therapy practice targeting cerebral palsy was confirmed. It is expected that this result will be useful in establishing mirror therapy as an interventional program.

Do Robotics and Virtual Reality Add Real Progress to Mirror Therapy Rehabilitation? A Scoping Review

“…In the present included studies, computerized or robotic sessions occurred mainly 5/weeks during 30 minutes (see Results/Type of intervention). However, standard mirror therapy sessions are also frequent [ 4 , 5 ]. In addition, the greater effect of robotic or virtual reality rehabilitation rather than conventional rehabilitation is not sure.…”

“…However, there is evidence of the effectiveness of first-generation mirror therapy for some indications [ 3 – 5 ]. Second-generation therapies are also more expensive.…”

“…It does not seem reasonable to develop new devices given the costs, time, and resources required, but rather to assess existing devices, especially in the case of public funding. On the other hand, research on mirror therapy with a real mirror or mirror box should continue to emerge given the good quality of evidence already available for certain indications [ 3 – 5 ]. If a new literature review is conducted on second-generation mirror therapy, search engine queries to identify studies should use comprehensive keywords (see Table S3 in Supplementary Materials).…”

“…This standard mirror therapy has been used in rehabilitation for multiple indications since the 1990s [2]. A good level of evidence supports some of these indications, particularly for cerebrovascular accidents in adults [3, 4] and cerebral palsy in children [5]. Cost is very low, because a simple little and not specifically dedicated mirror can be used [1].…”

Effect of Mirror Therapy on Upper Limb Function: A Single Subject Study

“…Similar to the previous work, one can see the gains of the participants in this study (Figures 2, 3 and 4). A previous systematic review conducted on children and adolescents with spastic hemiplegic cerebral palsy declared that the MVF shows a promising therapeutic effect on hand function [20,21]. In addition, Grunt et al [22] found that subjects with spastic hemiplegic cerebral palsy gained benefit from MVF by evaluating neurophysiological evidence that showed a significant increase in the excitability of primary motor cortex, following the application of MVF in children and adolescents with hemiparesis.…”