Mirror Therapy Improves Hand Function in Subacute Stroke: A Randomized Controlled Trial

Abstract 

Yavuzer G, Selles R, Sezer N, Sütbeyaz S, Bussmann JB, Köseoğlu F, Atay MB, Stam HJ. Mirror therapy improves hand function in subacute stroke: a randomized controlled trial.

Objective

To evaluate the effects of mirror therapy on upper-extremity motor recovery, spasticity, and hand-related functioning of inpatients with subacute stroke.

Design

Randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 6 months.

Setting

Rehabilitation education and research hospital.

Participants

A total of 40 inpatients with stroke (mean age, 63.2y), all within 12 months poststroke.

Interventions

Thirty minutes of mirror therapy program a day consisting of wrist and finger flexion and extension movements or sham therapy in addition to conventional stroke rehabilitation program, 5 days a week, 2 to 5 hours a day, for 4 weeks.

Main Outcome Measures

The Brunnstrom stages of motor recovery, spasticity assessed by the Modified Ashworth Scale (MAS), and hand-related functioning (self-care items of the FIM instrument).

Results

The scores of the Brunnstrom stages for the hand and upper extremity and the FIM self-care score improved more in the mirror group than in the control group after 4 weeks of treatment (by 0.83, 0.89, and 4.10, respectively; all P<.01) and at the 6-month follow-up (by 0.16, 0.43, and 2.34, respectively; all P<.05). No significant differences were found between the groups for the MAS.

Conclusions

In our group of subacute stroke patients, hand functioning improved more after mirror therapy in addition to a conventional rehabilitation program compared with a control treatment immediately after 4 weeks of treatment and at the 6-month follow-up, whereas mirror therapy did not affect spasticity.

Key Words: Cerebrovascular accident, Feedback, Imagery (psychotherapy), Motor skills, Rehabilitation