Effect of home-based mirror therapy on lower limb function in patients with stroke: A randomized controlled trial

Maneesha Deshpande, Franny Nathani

Abstract


Stroke is a global health-care problem that is common, serious, and disabling. The rehabilitation of impaired lower limb functioning post stroke is a major issue and approximately 30% of patients with chronic stroke have persistent difficulties in independent ambulation. Hence this study was performed with the objective of assessing the efficacy of Mirror Therapy on lower limb function in patients with stroke as a home based program. 30 subjects meeting the inclusion criteria were selected and divided into conventional therapy (CT group) (n=15) and Mirror + conventional therapy (MT+CT) group (n=15). Fugl Meyer lower extremity score was assessed at baseline. Both the study groups performed conventional treatment for approximately 40 minutes/ day, 6 days/week for a period of 4 weeks. In addition to conventional treatment, the Mirror Therapy plus Conventional Therapy (MT+CT) group received an additional exercise program to be performed for the non-affected extremity, against the reflecting surface of the mirror and observing the mirror image of the moving limb. Re-assessment of the outcome measure was done after the intervention of 4 weeks. Data analysis showed significant changes in the Fugl Meyer Assessment scores of the CT group (Control) (p=0.02) and MT+CT (Experimental) group (p=0.0001). On analyzing the difference in the mean scores of both the groups, FMA score showed significant changes (p=0.02).

Keywords: Mirror therapy, Lower limb, Fugl meyer assessment, Home-based therapy.

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References


Mohan U. Effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke: a randomized sham-controlled pilot trial. Ann Indian Acad Neurol. 2013;16(4):634.

Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Gait Posture. 2018;63:208-20.

Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8(8):741-54.

Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2012;(3):CD008449.

Sütbeyaz 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;88:555‑9.

Yavuzer G, Selles R, Sezer N, Sütbeyaz S, Bussmann JB, Köseoğlu F, et al. Mirror therapy improves hand function ing subacute stroke: A randomized controlled trial. Arch Phys Med Rehabil. 2008;89:393‑8.

Sanford J, Moreland J, Swanson LR, Stratford PW, Gowland C. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther. 1993;73(7):447-54.

van der Lee JH, Beckerman H, Lankhorst GJ, Bouter LM. The responsiveness of the Action Research Arm test and the Fugl-Meyer Assessment scale in chronic stroke patients. J Rehabil Med. 2001;33(3):110-3.

Dohle C, Püllen J, Nakaten A, Küst J, Rietz C, Karbe H. Mirror therapy promotes recovery from severe hemiparesis: a randomized controlled trial. Neurorehabil Neural Repair. 2009;23(3):209-17.

Fukumura K, Sugawara K, Tanabe S, Ushiba J, Tomita Y. Influence of mirror therapy on human motor cortex. Int J Neurosci. 2007;117(7):1039-48.

Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain. 2009:awp135.

Carr JH, Shepherd RB. Neurological Rehabilitation: Optimizing motor performance. 2nd ed. Indian Reprint ISBN: 978-0-7020-4468-7. First Reprinted in India 2011.

Garry MI, Loftus A, Summers JJ. Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability. Exp Brain Res. 2005;163(1):118-22.