The effect of mirror therapy on motor abilities of patients with stroke

Document Type: Original Quantitative and Qualitative Research Paper

Authors

1 Phd candidate in Nursing, department of medical-surgical nursing, School of nursing and midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 MS in Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 Instructor of Nursing, Department of medical-surgical Nursing, School of nursing and midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

4 Associate professor of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Stroke is one of the major causes of disability. Therefore, it is important to introduce and develop new treatment approaches in order to improve and enhance post stroke recovery process for medical, social and economical purposes.
Aim: To determine the effect of mirror therapy on motor ability of patients with stroke.
Methods: This Randomized Controlled Trial was conducted on 38 patients with stroke, hospitalized in Imam Reza and Quaem hospital in Mashhad. They were randomly allocated into two groups of control (18 patients) and mirror therapy group (20 patients). In an experimental group, twenty 30minute sessions were performed daily or every other day. In this procedure, patients performed a range of motion of upper and lower extremities of healthy side in front of the mirror and observed only the mirror image. In additional to mirror therapy in both groups, the routine program (physiotherapy and neuromuscular stimulation) was performed. Upper and lower extremity motor abilities were assessed before, during and after the intervention using motor recovery scale, function index measure and function ambulation classification. Finally, data were analyzed by SPSS version 14.
Results: Two groups showed no significant difference in terms of motor ability indexes and confounding variables before the intervention. Motor ability indexes, movement recovery and walking ability in mirror therapy group were significantly improved in comparison with control group after the intervention. (P>0.05)
Conclusion: Mirror therapy can improve motor ability of patients with stroke as a simple, inexpensive and patient-oriented treatment.

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Main Subjects


  1.  Habibzadeh H, Ghofranipour FA, Ahmadi F. The Effect of Self-Care Planning on The Daily Activities of Patiens With Cerebro-Vascular Accident Hospitalized at The Selected Urumia Hospital. Daneshvar Med 2007 Mar;14(67):9-17 ) Persian(.
  2. Saheb zamani M, Aliloo L, Shakibi A. Effect of Self Care on Rehabilitation in Patients with Hemiplgic Strok. Medical Sciences Journal of Islamic Azad University. 2007;17(4):213-8 ) Persian(.
  3. SHams Aldini A R, Holisaz M T, Keyhani M R. Comparison of Balance Abilities of Patients with Right and Left Hemiplegics Stroke. J Rehab.  2007; 8(3 (31)): 35-8 ) Persian(.
  4. Akbari A, Karimi H, Kazemnejad A, Ghabaii M. The Effect of Strengthening Exercises on Biomechanical Parameters of Gait in Chronic Hemiparesis Following Stroke. J Qazvin Univ Med Sci. 2005;9(36):8-15 ) Persian(.
  5. Shahi moridi A, Asgharnia H, Sheykh fathelahi M. The Frequency of Sensorimotor Dysfunctions During The First 3 Months After Stroke Hospitalized Patients in Aliibn Abitaleb Hospital in Rafsanjan City. J Rafsanjan Univ Med Sci. 2002;1(4):241-51) Persian(.
  6. Hossini M, Khankeh HR, Alaee S, Dibaei M. Determine. The Effect of Home Care on Complication Resul Ting from Musculoskeletal System Immobility of Stroked Patients. J Rehab (Persian). 2004;5(4(19)):35-42.
  7. Sutbeyaz S, Yavuzer G, Sezer N, Koseoglu BF. Mirror Therapy Enhances Lower-Extremity Motor Recovery and Motor Functioning After Stroke: a Randomized Controlled Trial. Arch Phys Med Rehabil. 2007 May;88(5):555-9
  8. Hosseianabadi M R,Taheri H R, Alavinia S M, Keavanlou F, Seyedahmadi M, Rahimi N.The Impact Four Week of Physical Therapy on Exaggerated Muscle Tonicity, Balance And Quality of Life in Hemi Paresis Patients. Journal of North Khorasan University of Medical Sciences. 2011; 3(2 (8)):17-22 (Persian).
  9. Nokhostin Ansari N, Naghdi S. Rehabilitation Techniques for Strok. 1 ed. Tehran: Arjmand; 2010 (Persian).
  10. McCabe C, Haigh R, Blake D. Mirror Visual Feedback for The Treatment of Complex Regional Pain Syndrome (Type 1). Current Pain and Headache Reports. 2008;12(2):103-7
  11. Yavuzer G, Selles R, Sezer N, Sutbeyaz S, Bussmann JB, Koseoglu F, et al. Mirror Therapy Improves Hand Function in Subacute Stroke: a Randomized Controlled Trial. Arch Phys Med Rehabil. 2008 Mar; 89(3): 393-8.
  12. Wilcher DG, Chernev I, Yan K. Combined Mirror Visual and Auditory Feedback Therapy for Upper Limb Phantom Pain: a Case Report. J Med Case Reports. 2011; 5:41.
  13.  Wu CY, Huang PC, Chen YT, Lin KC, Yang HW. Effects of Mirror Therapy on Motor and Sensory Recovery in Chronic Stroke: a Randomized Controlled Trial. Arch Phys Med Rehabil.2013 Jun; 94(6): 1023-30.
  14.  Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror Therapy for Improving Motor Function After Stroke. Stroke. 2013;44(1):e1-2.
  15.  Radajewska A, Opara JA, Kucio C, B┼éaszczyszyn M, Mehlich K, Szczygiel J. The Effects of Mirror Therapy on Arm and Hand Function in Subacute Stroke in Patients. Int J Rehabil Res. 2013 Mar; 22 [Epub ahead of print].
  16.  Lee MM, Cho H, Song CH. The Mirror Therapy Program Enhances Upper-Limb Motor Recovery And Motor Function in Acute Stroke Patients. Am J Phys Med Rehabil 2012; 91:689-700.
  17. Langhorne P, Bernhardt J, Kwakkel G. Stroke Rehabilitation. 2011; Lancet 377:1693–702.
  18. Michielsen ME, Smits M, Ribbers GM, Stam HJ, van der Geest JN, JBJ Bussmann, Selles RW. The Neuronal Correlates of Mirror Therapy: an FMRI Study on Mirror Induced Visual Illusions in Patients with Stroke. J Neurol Neurosurg Psychiatry. 2011Apr; 82(4):393-8.
  19. Malouin F, Potvin M, Prevost J, et al. Use of an Intensive Taskoriented Gait Training Program in a Series of Patients with Acute Cerebrovascular Accidents. Phys Ther. 1992;72:781–89.
  20. Dickstein R, Dunsky A, Marcovitz E. Motor Imagery for Gait Rehabilitation in Post-Stroke Hemiparesis. Phys Ther. 2004; 84: 1167-77.
  21. Sathian K. Mirror, Mirror, Move My Manu! Neurorehabil Neural Repair 2009 Mar-Apr; 23(3):207-8.  
  22. Hamdy S, Rothwell JC, Aziz Q, Singh KD, Thompson DG. Long-Term Reorganization of Human Motor Cortex Driven by Shortterm Sensory Stimulation. Nat Neurosci. 1998May;1(1):64-8.
  23. Flor H, Diers M. Sensori Motor Training and Cortical Reorganization. NeuroRehabilitation. 2009;25(1):19-27.
  24. Shinoura N, Suzuki Y, Watanabe Y, et al. Mirror Therapy Activatesoutside of Cerebellum and Ipsilateral M1. NeuroRehabilitation 2008; 23(3):245-52.
  25. Matthys K, Smits M, Van der Geest JN, Van der Lugt A, Seurinck R, Stam HJ, Selles RW. Mirror-Induced Visual Illusion of Hand Movements: a Functionalmagnetic Resonance Imaging Study. Arch Phys Med Rehabil. 2009 Apr; 90(4): 675–81.