Effects of mirror therapy in recovering strength and function of the upper limbs in chronic stroke patients: A randomized controlled trial

Abstract

Background : Stroke is one of the biggest healthcare problems in developing countries. Majority of the stroke patients have persistent upper limbs motor impairment. One of the promising methods to assist motor improvement is mirror therapy. However, the evidence supporting efficacy of this intervention in chronic stroke patients is limited, due to small sample size and non-RCTs in most currently available studies.

Objective : To investigate whether mirror therapy, as an adjunct program, can help chronic stroke survivors regain their upper limbs’ motor functions, handrelated functions and reduce spasticity.

Methods : Forty-four chronic stroke patients were divided into 2 groups, who underwent clinical assessment for adjunct mirror therapy versus placebo. Clinical data of both the intervention and placebo were compared at
baseline, 2, 4, 8 and 12 weeks. Brunnstrom stage of recovery, motor assessment scale of the upper extremity, modified Ashworth scale, and tip and lateral pinch gauges were assessed after the intervention at baseline, weeks: 2, 4, 8 and 12.

Results : There were significant improvements within the intervention group when compared to the baseline levels for Brunnstrom hand and arm, Barthel activity as early as 2 weeks, and Motor Assessment Scale and lateral pinch strength as early as 8 weeks. This improvement also continued until the end of the study. Significant recovery between the groups was seen for the Brunnstrom hand at only 2nd week.

Conclusion : Mirror therapy with the conventional rehabilitation program may help to improve the Brunnstrom recovery stage for hand as early as 2nd week when compared with the sham therapy. The use of mirror therapy is
simple, easy, cheap and can be done at the home.