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.
Similar content being viewed by others
References
Lloyd-Jones D, Adams RJ, Brown TM et al (2010) Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation 121:e46–e215
Lai SM, Studenski S, Duncan PW, Perera S (2002) Persisting consequences of stroke measured by the Stroke Impact Scale. Stroke 33:1840–1844
Broeks JG, Lankhorst GJ, Rumping K, Prevo AJ (1999) The long-term outcome of arm function after stroke: results of a follow-up study. Disabil Rehabil 21:357–364
Pang MY, Harris JE, Eng JJ (1996) A community-based upper- extremity group exercise program improves motor function and performance of functional activities in chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil 87:1–9
Ramachandran VS, Rogers-Ramachandran D (1996) Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci 263:377–386
Moseley GR (2004) Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain 108:192–198
Rothgangel AS, Braunn SM, Beurskens AJ, Seitz RJ, Wade DT (2011) The clinical aspects of mirror therapy in rehabilitation: a systematic review of the literature. Int J Rehabil Res 34:1–3
Tung ML, Murphy IC, Griffin SC et al (2014) Observation of limb movements reduces phantom limb pain in bilateral amputees. Ann Clin Transl Neurol. 1:633–638
Rossiter HE, Borrelli MR, Borchert RJ, Bradbury D, Ward NS (2014) Cortical mechanisms of Mirror therapy after stroke. Neurorehabil Neural Repair. doi:10.1177/1545968314554622
Michielsen ME, Selles RW, van der Geest JN et al (2011) Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: a phase II randomized controlled trial. Neurorehabil Neural Repair 25:223–233
Avanzino L, Raffo A, Pelosin E, Ogliastro C, Marchese R, Ruggeri P, Abbruzzese G (2014) Training based on mirror visual feedback influences transcallosal communication. Eur J Neurosci 40:2581–2588
Garry MI, Loftus A, Summers JJ (2005) Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability. Exp Brain Res 163:118–122
Michielsen ME, Smits M, Ribbers GM et al (2011) The neuronal correlates of mirror therapy: an fMRI study on mirror induced visual illusions in patients with stroke. J Neurol Neurosurg Psychiatry 82:393–398
Deconinck FJ, Smorenburg AR, Benham A, Ledebt A, Feltham MG, Savelsbergh GJ (2014) Reflections on Mirror therapy: a systematic review of the effect of mirror visual feedback on the brain. Neurorehabil Neural Repair. pii: 1545968314546134 (Epub ahead of print)
Ezendam D, Bongers RM, Jannink MJ (2009) Systematic review of the effectiveness of mirror therapy in upper extremity function. Disabil Rehabil 31:2135–2149
Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C (2012) Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev 3:CD008449
Pollock A, Farmer SE, Brady MC et al (2014) Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews 11:CD010820
Nilsen DM, Gillen G, Geller D, Hreha K, Osei E, Saleem GT (2015) Effectiveness of interventions to improve occupational performance of people with motor impairments after stroke: an evidence-based review. Am J Occup Ther 69:6901180030p1-9
Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S (1975) The post-stroke hemiplegic patient. A method for evaluation of physical performance. Scand J Rehabil Med 7:13–31
Gladstone DJ, Danells CJ, Black SE (2002) The Fugl–Meyer Assessment of Motor Recovery after Stroke: a critical review of its measurement properties. Neurorehabil Neural Repair 16:232–240
Ashworth B (1964) Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 192:540–542
Bhakta BB, Cozens JA, Chamberlain MA, Bamford JM (2000) Impact of botulinum toxin type A on disability and carer burden due to arm spasticity after stroke: a randomised double blind placebo controlled trial. J Neurol Neurosurg Psychiatry 69:217–221
Kleim JA, Jones TA, Schallert T (2003) Motor enrichment and the induction of plasticity before or after brain injury. Neurochem Res 28:1757–1769
Whishaw IQ (2000) Loss of the innate cortical engram for action patterns used in skilled reaching and the development of behavioral compensation following motor cortex lesions in the rat. Neuropharmacology 39:788–805
Carey JR, Kimberley TJ, Lewis SM, Auerbach EJ, Dorsey L et al (2002) Analysis of fMRI and finger tracking training in subjects with chronic stroke. Brain 125:773–788
Rossini PM, Dal Forno G (2004) Neuronal post-stroke plasticity in the adult. Restor Neurol Neurosci 22:193–206
Kleim JA, Jones TA (2008) Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. Journal of Speech, Language, and Hearing Research 51:S225–S239
Flor H, Diers M (2009) Sensorimotor training and cortical reorganisation. Neurorehabilitation 25:19–27
O’Bryant O, Bernier B, Jones TA (2007) Abnormalities in skilled reaching movements are improved by peripheral anesthetization of the less-affected forelimb after sensorimotor cortical infarcts in rats. Behav Brain Res 177:298–307
Dohle C, Pullen J, Nakaten A, Kust J, Rietz C, Karbe H (2009) Mirror therapy promotes recovery from severe hemiparesis: a randomized controlled trial. Neurorehabilitation and neural repair 23:209–217
Invernizzi M, Negrini S, Carda S (2013) The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients. Eur J Phys Rehabil Med 49:311–317
Yavuzer G, Selles R, Sezer N et al (2008) Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil 89:393–398
Lee MM, Cho HY, Song CH (2012) The mirror therapy program enhances upper-limb motor recovery and motor function in acute stroke patients. Am J Phys Med Rehabil 91:689–696
Yoon JA, Koo BI, Shin MJ, Shin YB, Ko HY, Shin YI (2014) Effect of constraint-induced movement therapy and mirror therapy for patients with subacute stroke. Ann Rehabil Med 38:458–466
Acknowledgments
The research is not financed.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standard
The authors declare that participation were voluntary, all subjects gave their informed consent before entering the study. The study was carried out in accordance with the Helsinki Declaration.
Informed consent
Informed consent for publication was obtained from the patient.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mirela Cristina, L., Matei, D., Ignat, B. et al. Mirror therapy enhances upper extremity motor recovery in stroke patients. Acta Neurol Belg 115, 597–603 (2015). https://doi.org/10.1007/s13760-015-0465-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13760-015-0465-5