Therapeutic Role of Additional Mirror Therapy on the Recovery of Upper Extremity Motor Function after Stroke: A Single-Blind, Randomized Controlled Trial

Abstract

Background. Rehabilitation of upper extremity hemiplegia after stroke remains a great clinical challenge, with only 20% of patients achieving a basic return to normal hand function. How to promote the recovery of motor function at an early stage is crucial to the life of the patient. Objectives. To invest the effects of additional mirror therapy in improving upper limb motor function and activities of daily living in acute and subacute stroke patients, and further explore the effects of other factors on the efficacy of MT. Methods. Participants who presented with unilateral upper extremity paralysis due to a first ischemic or hemorrhagic stroke were included in the study. They were randomly allocated to the experimental or control group. Patients in the control group received occupational therapy for 30 minutes each session, six times a week, for three weeks, while patients in the experimental group received 30 minutes of additional mirror therapy based on occupational therapy. The primary outcome measures were Fugl-Meyer Assessment—upper extremity (FMA-UE), Action Research Arm Test (ARAT), and Instrumental Activity of Daily Living (IADL) which were evaluated by two independent occupational therapists before treatment and after 3-week treatment. A paired t -test was used to compare the values between pretreatment and posttreatment within an individual group. Two-sample t -test was utilized to compare the changes (baseline to postintervention) between the two groups. Results. A total of 52 stroke patients with unilateral upper extremity motor dysfunction who were able to actively cooperate with the training were included in this study. At baseline, no significant differences were found between groups regarding demographic and clinical characteristics ( P > 0.05 for all). Upper limb motor function and ability to perform activities of daily living of the patients were statistically improved in both groups towards the third week ( P < 0.05 ). In addition, statistical analyses showed more significant improvements in the score changes of FMA-UE and IADL in the experimental group compared to the control group after treatment ( P < 0.05 ), but no significant difference was observed in the ARAT score changes between the two groups ( P > 0.05 ). The subgroup analysis showed that no significant heterogeneity was observed in age, stroke type, lesion side, and clinical stage ( P > 0.05 ). Conclusion. In conclusion, some positive changes in aspects of upper limb motor function and the ability to perform instrumental activities of daily living compared with routine occupational therapy were observed in additional mirror therapy. Therefore, the application of additional mirror therapy training should be reconsidered to improve upper extremity motor in stroke patients.

Efficacy of a Rehabilitation Program Using Mirror Therapy and Cognitive Therapeutic Exercise on Upper Limb Functionality in Patients with Acute Stroke

“…Furthermore, significant and highly significant differences were observed between the CG and the two EG, indicating a superior improvement for both EG compared to the CG, except for the range of motion and pain domain. These results are consistent with other studies suggesting that groups incorporating MT and cognitive exercises show greater motor and functional recovery and better self-care compared to CG [ 40 , 41 , 42 ].…”

“…The statistically significant differences in global limb functionality, motor domain and sensory domain are consistent, with several studies indicating that intervention using MT and CTE improves the total FMA-EU score, thus increasing upper limb functionality and motor domain, which in turn improves motor function and ADLs [39,40].…”

“…However, many times when patients receive traditional treatment, they lack attention and initiative, negatively impacting the activation of the corresponding brain cortex, thereby affecting neuroplasticity and functional reorganization [ 46 ]. In this regard, MT necessitates active movement of bilateral upper limbs, which can enhance patient initiative [ 40 ]. Furthermore, it also requires simultaneously observing the reflection in the mirror of normal limb movements, potentially enhancing patient focus, favoring more cortical activation than traditional rehabilitation training.…”

Rehabilitasi Pasca Stroke Ditinjau dari Fungsi Motorik : A Systematic Review

“…Kegiatan setiap hari lebih banyak atau tergantung bantuan orang lain . Dalam artikel (Wen et al, 2022) perawatan yang diperlukan setiap pasien stroke bisa mungkin berbeda dengan pasien yang lainnya. Hal ini tergantung pada kebutuhan dan gejala pasien stroke.…”

Hemiplejik hastalarda ergoterapinin üst ekstremite fonksiyonu ve günlük yaşam aktivitelerine etkisi

“…8 Early exercise interventions are necessary to improve upper extremity motor functions and activities of daily living (ADL), as persistent upper extremity dysfunction is strongly associated with decreased activities of daily living and poor quality of life after stroke. [9][10][11] Occupational therapy (OT) is a part of medical rehabilitation therapy aimed at restoring, strengthening and increasing the person's performance in specified activities and tasks in order to improve health, reduce and correct pathology. 4 Studies have shown that OT shortens the length of hospital stay, increases activities of daily living, and increases the level of independence in stroke patients.…”