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Effects of Mirror Therapy on Motor and Sensory Recovery in Chronic Stroke: A Randomized Controlled Trial

  • Ching-Yi Wu
    Affiliations
    Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
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  • Pai-Chuan Huang
    Affiliations
    Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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  • Yu-Ting Chen
    Affiliations
    Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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  • Keh-Chung Lin
    Correspondence
    Corresponding author: Keh-Chung Lin, ScD, OTR, School of Occupational Therapy, College of Medicine, National Taiwan University and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 17, F4, Xu Zhou Road, Taipei, Taiwan.
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
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  • Hsiu-Wen Yang
    Affiliations
    Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, Zhongxiao Branch of Taipei City Hospital, Taipei, Taiwan
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Published:February 18, 2013DOI:https://doi.org/10.1016/j.apmr.2013.02.007

      Abstract

      Objective

      To compare the effects of mirror therapy (MT) versus control treatment (CT) on movement performance, motor control, sensory recovery, and performance of activities of daily living in people with chronic stroke.

      Design

      Single-blinded, randomized controlled trial.

      Setting

      Four hospitals.

      Participants

      Outpatients with chronic stroke (N=33) with mild to moderate motor impairment.

      Interventions

      The MT group (n=16) received upper extremity training involving repetitive bimanual, symmetrical movement practice, in which the individual moves the affected limb while watching the reflective illusion of the unaffected limb's movements from a mirror. The CT group received task-oriented upper extremity training. The intensity for both groups was 1.5 hours/day, 5 days/week, for 4 weeks.

      Main Outcome Measurements

      The Fugl-Meyer Assessment; kinematic variables, including reaction time, normalized movement time, normalized total displacement, joint recruitment, and maximum shoulder-elbow cross-correlation; the Revised Nottingham Sensory Assessment; the Motor Activity Log; and the ABILHAND questionnaire.

      Results

      The MT group performed better in the overall (P=.01) and distal part (P=.04) Fugl-Meyer Assessment scores and demonstrated shorter reaction time (P=.04), shorter normalized total displacement (P=.04), and greater maximum shoulder-elbow cross-correlation (P=.03). The Revised Nottingham Sensory Assessment temperature scores improved significantly more in the MT group than in the CT group. No significant differences on the Motor Activity Log and the ABILHAND questionnaire were found immediately after MT or at follow-up.

      Conclusions

      The application of MT after stroke might result in beneficial effects on movement performance, motor control, and temperature sense, but may not translate into daily functions in the population with chronic stroke.

      Keywords

      List of abbreviations:

      ADL (activities of daily living), CT (control treatment), FMA (Fugl-Meyer Assessment), MAL (Motor Activity Log), MT (mirror therapy), rNSA (Revised Nottingham Sensory Assessment), UE (upper extremity)
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