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Mirror therapy enhances upper extremity motor recovery in stroke patients

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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.

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References

  1. 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

    Article  PubMed  Google Scholar 

  2. Lai SM, Studenski S, Duncan PW, Perera S (2002) Persisting consequences of stroke measured by the Stroke Impact Scale. Stroke 33:1840–1844

    Article  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  Google Scholar 

  5. Ramachandran VS, Rogers-Ramachandran D (1996) Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci 263:377–386

    Article  CAS  PubMed  Google Scholar 

  6. Moseley GR (2004) Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain 108:192–198

    Article  CAS  PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    Article  PubMed Central  PubMed  Google Scholar 

  9. 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

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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)

  15. Ezendam D, Bongers RM, Jannink MJ (2009) Systematic review of the effectiveness of mirror therapy in upper extremity function. Disabil Rehabil 31:2135–2149

    Article  PubMed  Google Scholar 

  16. 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

  17. Pollock A, Farmer SE, Brady MC et al (2014) Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews 11:CD010820

  18. 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

  19. 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

    CAS  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. Ashworth B (1964) Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 192:540–542

    CAS  PubMed  Google Scholar 

  22. 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

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Kleim JA, Jones TA, Schallert T (2003) Motor enrichment and the induction of plasticity before or after brain injury. Neurochem Res 28:1757–1769

    Article  CAS  PubMed  Google Scholar 

  24. 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

    Article  CAS  PubMed  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

  26. Rossini PM, Dal Forno G (2004) Neuronal post-stroke plasticity in the adult. Restor Neurol Neurosci 22:193–206

    PubMed  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. Flor H, Diers M (2009) Sensorimotor training and cortical reorganisation. Neurorehabilitation 25:19–27

    PubMed  Google Scholar 

  29. 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

    Article  PubMed Central  PubMed  Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. 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

    CAS  PubMed  Google Scholar 

  32. 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

    Article  PubMed  Google Scholar 

  33. 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

    Article  PubMed  Google Scholar 

  34. 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

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The research is not financed.

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The authors declare that they have no conflict of interest.

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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.

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Informed consent for publication was obtained from the patient.

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Correspondence to Daniela Matei.

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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

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  • DOI: https://doi.org/10.1007/s13760-015-0465-5

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