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Rehabilitation is a crucial part of stroke recovery to help them regain use of their limb. This study aimed to compare the effectiveness of long-term mirror therapy training with conventional rehabilitation therapy on neurological and recovery of the upper limb in acute stroke patients. In this randomized and assessor-blinded control study, 20 acute stroke patients were analyzed and allocated to a case (n = 10, 50.6 ± 17.90 years) and control group (n = 10, 55.9 ± 11.25 years). All the participants performed daily home exercises for 12 weeks. The patients in the control group were treated with Conventional Therapy (CT), and a group of cases was treated with Mirror Therapy (MT) alone program. The outcome measurements were assessed by a therapist blinded assessor using Fugl-Meyer Assessment (FMA) upper extremity score, Brunnstrom recovery stages (BRS), Modified Ashworth Scale (MAS) and Muscle Strength to evaluate upper limb motor function and motor recovery. Data were analyzed using Wilcoxon and Mann-Whitney U tests to compare within-groups and between-group differences. The results revealed that, after 12 weeks of treatment, patients of both groups presented statistically significant improvements in all the measured variables (p-value < 0.05). Compared with the control group, the patients of the MT group had greater improvement in the proximal movement portion of the FMA upper extremity mean score change (15.8 ± 3.2 versus 10.0 ± 2.7, p = 0.002). While, there were no differences in other variables (p-value > 0.05). There were also no adverse events. It suggests that 12 weeks of MT training alone was likely to improve the upper limb's motor recovery and daily living activity in acute stroke patients than conventional therapy, if treated early.
V. L. Feigin, B. Norrving, and G. A. Mensah, “Global burden of stroke,” Circulation Research, vol. 120, pp. 439–448, Feb. 2017.
Y. Nilanont, S. Nidhinandana, N. C. Suwanwela, S. Hanchaiphiboolkul, T. Pimpak, P. Tatsanavivat, G. Saposnik, and N. Poungvarin, “Quality of acute ischemic stroke care in Thailand: A prospective multicenter countrywide cohort study,” Journal of Stroke and Cerebrovascular Diseases, vol. 23, pp. 213–219, Feb. 2014.
S. Hanchaiphiboolkul, N. Poungvarin, S. Nidhinandana, N. C. Suwanwela, P. Puthkhao, S. Towanabut, T. Tantirittisak, J. Suwantamee, and M. Samsen, “Prevalence of stroke and stroke risk factors in Thailand: Thai epidemiologic stroke (TES) study,” Journal of the Medical Association of Thailand, vol. 94, pp. 427–436, Apr. 2011.
S. Palangrit and S. Muengtaweepongsa, “Risk factors of stroke in Pathum Thani province, Thailand,” Journal of the Medical Association of Thailand, vol. 98, pp. 649–655, Jul. 2015.
A. T. Patel, P. W. Duncan, S. M. Lai, and S. Studenski, “The relation between impairments and functional outcomes poststroke,” Archives of Physical Medicine and Rehabilitation, vol. 81, pp. 1357–1363, Oct. 2000.
N. K. LeBrasseur, S. P. Sayers, M. M. Ouellette, and R. A. Fielding, “Muscle impairments and behavioral factors mediate functional limitations and disability following stroke,” Physical Therapy, vol. 86, pp. 1342–1350, Oct. 2006.
A. Heller, D. T. Wade, V. A. Wood, A. Sunderland, R. L. Hewer, and E. Ward, “Arm function after stroke: Measurement and recovery over the first three months,” Journal of Neurology, Neurosurgery and Psychiatry, vol. 50, pp. 714–719, Jun. 1987.
H. Nakayama, H. S. Jorgensen, H. O. Raaschou, and T. S. Olsen, “Recovery of upper extremity function in stroke patients: The copenhagen stroke study,” Archives of Physical Medicine and Rehabilitation, vol. 75, pp. 394–398, Apr. 1994.
J. H. Morris, F. van Wijck, S. Joice, and M. Donaghy, “Predicting health related quality of life 6 months after stroke: The role of anxiety and upper limb dysfunction,” Disability and Rehabilitation, vol. 35, pp. 291–299, Feb. 2013.
M. Franceschini, F. La Porta, M. Agosti, and M. Massucci, “ICR2 group. Is health-related-quality of life of stroke patients influenced by neurological impairments at one year after stroke,” European Journal of Physical and Rehabilitation Medicine, vol. 46, pp. 389–399, Sep. 2010.
M. Numfu, A. Riel, and F. Noel, “Virtual reality technology for maintenance training,” Applied Science and Engineering Progress, vol. 13, pp. 274–282, Jul. 2020.
S. Samuelkamaleshkumar, S. Reethajanetsureka, P. Pauljebaraj, B. Benshamir, S. M. Padankatti, and J. A. David, “Mirror therapy enhances motor performance in the paretic upper limb after stroke: A pilot randomized controlled trial,” Archives of Physical Medicine and Rehabilitation, vol. 95, pp. 2000–2005, Nov. 2014.
G. Yavuzer, R. Selles, N. Sezer, S. Sütbeyaz, J. B. Bussmann, F. Köseoglu, M. B. Atay, and H. J. Stam, “Mirror therapy improves hand function in subacute stroke: A randomized controlled trial,” Archives of Physical Medicine and Rehabilitation, vol. 89, pp. 393–398, Mar. 2008.
W. Zeng, Y. Guo, G. Wu, X. Liu, and Q. Fang, “Mirror therapy for motor function of the upper extremity in patients with stroke: A meta-analysis,” ASEAN Journal of Rehabilitation Medicine, vol. 50, pp. 8–15, Jan. 2018.
I. Yeldan, B. E. Huseyinsinoglu, B. Akinci, E. Tarakci, S. Baybas, and A. R. Ozdincler, “The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients,” The Journal of Physical Therapy Science, vol. 27, pp. 3519–3524, Nov. 2015.
E. L. Altschuler, S. B. Wisdom, L. Stone, C. Foster, D. Galasko, D. M. Llewellyn, and V. S. Ramachandran, “Rehabilitation of hemiparesis after stroke with a mirror,” The Lancet, vol. 353, pp. 2035–2036, Jun. 1999.
A. Pollock, G. Baer, P. Campbell, P. L. Choo, A. Forster, J. Morris, and V. M. Pomeroy, “Physical rehabilitation approaches for the recovery of function and mobility following stroke,” Cochrane Library: Cochrane Reviews, vol. 2014, no. 4, Apr. 2014, doi: 10.1002/14651858. CD001920.pub3.
J. Champaiboon, R. Rueangyu, V. Sontim, and K. Piravej, “Effects of mirror therapy in recovering strength and function of the upper limbs in chronic stroke patients: A randomized controlled trial,” Chulalongkorn Medical Journal, vol. 61, pp. 165–181, Mar. 2017.
S. K. Suzanne, E. Tara, and R. M. Norman, “Effects and adherence of mirror therapy in people with chronic upper limb hemiparesis: A preliminary study,” ISRN Rehabilitation, vol. 2012, pp. 1–9, Nov. 2012.
W. Caroline, M. W. Heymans, E. E. H. van Wegen, and G. Kwakkel, “How to design clinical rehabilitation trials for the upper paretic limb early post stroke?,” Trials, vol. 17, pp. 468– 476, Sep. 2016.
J. Boonpitak, S. Tongpasert, and A. Kovindha, “Mirror therapy to improve hand and arm use in patients with chronic stroke: A pilot study,” Journal of Thai Rehabilitation Medicine, vol. 20, pp. 20–28, Jan. 2010.
J. Sanford, J. Moreland, L. R. Swanson, P. W. Stratford, and C. Gowland, “Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke,” Physical Therapy, vol. 73, pp. 447–454, Jul. 1993.
D. J. Gladstone, C. J. Danells, and S. E. Black, “The Fugl-Meyer assessment of motor recovery after stroke: A critical review of its measurement properties,” Neurorehabilitation and Neural Repair, vol. 16, pp. 232–240, Sep. 2002.
K. Sathian, A. I. Greenspan, and S. L. Wolf, “Doing it with mirrors: A case study of a novel approach to neurorehabilitation,” Neurorehabilitation and Neural Repair, vol. 14, pp. 73–76, Feb. 2000.
C. Gowland, P. Stratford, M. Ward, J. Moreland, W. Torresin, S. van Hullenaar, J. Sanford, S. Barreca, B. Vanspall, and N. Plews, “Measuring physical impairment and disability with the Chedoke-McMaster stroke assessment,” Stroke, vol. 24, pp. 58–63, Jan. 1993.
J. M. Gregson, M. Leathley, A. P. Moore, A. K. Sharma, T. L. Smith, and C. L. Watkins, “Reliability of the tone assessment scale and the modified ashworth scale as clinical tools for assessing poststroke spasticity,” Archives of Physical Medicine and Rehabilitation, vol. 80, pp. 1013–1016, Sep. 1999.
J. M. Gregson, M. J. Leathley, A. P. Moore, T. L. Smith, A. K. Sharma, and C. L. Watkins, “Reliability of measurements of muscle tone and muscle power in stroke patients,” Age and Ageing, vol. 29, pp. 223–228, 2000.
L. Santisteban, M. Térémetz, J. P. Bleton, J. C. Baron, M. A. Maier, and P. G. Lindberg, “Upper limb outcome measures used in stroke rehabilitation studies: A systematic literature review,” PLoS ONE, vol. 11, May 2016, doi:10. 1371/journal.pone.0154792.
M. Ehrensberger, D. Simpson, P. Broderick, C. Blake, F. Horgan, P. Hickey, J. OʼReilly, and K. Monaghan, “Unilateral strength training and mirror therapy in patients with chronic stroke: A pilot randomized trial,” American Journal of Physical Medicine & Rehabilitation, vol. 98, pp. 657–665, Aug. 2019.
M. Yagi, H. Yasunaga, H. Matsui, K. Morita, K. Fushimi, M. Fujimoto, T. Koyama, and J. Fujitani, “Impact of rehabilitation on outcomes in patients with ischemic stroke: A nationwide retrospective cohort study in Japan,” Stroke, vol. 48, pp. 740–746, Mar. 2017.
M. M. Lee, H. Cho, and C. H. Song, “The mirror therapy program enhances upper-limb motor recovery and motor functions in acute stroke patients,” American Journal of Physical Medicine & Rehabilitation, vol. 91, pp. 689–696, Aug. 2012.
P. Antoniotti, L. Veronelli, A. Caronni, A. Monti, E. Aristidou, M. Montesano, and M. Corbo, “No evidence of effectiveness of mirror therapy early after stroke: An assessor-blinded randomized controlled trial,” Clinical Rehabilitation, vol. 33, pp. 885–893, 2019.
J. A. Stevens and M. E. Stoykov, “Using motor imagery in the rehabilitation of hemiparesis,” Archives of Physical Medicine and Rehabilitation, vol. 84, pp. 1090–1092, Aug. 2003.