The Effect of Mirror Therapy on Cerebral Re-organization, Functional Motor Skills, and Quality of Life in Hemiplegic Cerebral Palsy
Condition: Spastic Hemiplegic Cerebral Palsy
MeSH terms: Muscle Spasticity; Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      The purpose of this study is to investigate brain reorganization, functional motor
      development, level of daily living activity and quality of life of upper extremity mirror
      therapy in children with spastic hemiplegic cerebral palsy. Several studies have reported
      increased use of the affected arm following rearrangement of cerebral re-organization with
      mirror therapy. The investigator's study is the first of its kind and was planned to evaluate
      the effectiveness of upper extremity mirror therapy in cerebral reorganization and functional
      motor skills in children with spastic hemiplegic cerebral palsy. Hypothesis of this study is
      that mirror therapy improves brain re-organisation, functional motor skills and daily living
      activities in unilateral spastic CP.
    

Detailed description: 
      Cerebral palsy (CP) is the most common neurodisability in children. It has been defined as a
      disorder of movement and posture due to a defect or lesion of the immature brain and as a
      group of non-progressive, but often changing motor impairment syndromes secondary to lesions
      or anomalies of the brain arising in the early stages of development.

      Characteristically, children with unilateral cerebral palsy (CP) have one well-functioning
      hand and one impaired hand.Common features of the hemiplegic hand are slowness, abnormal
      muscle tone, decreased strength, and coordination difficulties, which occur to a varying
      extent in children independently of age. Many children also have impaired sensibility and
      mirror movements. Perhaps most importantly, children with unilateral CP hav e varying degrees
      of limitation in their ability to handle objects in daily life. This limitation is most
      obvious insituations where two hands are needed. However, knowledge about bimanual ability in
      chil dren with unilateral CP and its development over time is scarce at present.

      To improve upper extremity function in children with unilateral CP, the mirror therapy is a
      promising approach. Mirror therapy for the first time, Ramachandran et al. has described for
      the treatment of phantom pain in amputee. Also in unilateral spastic CP mirror therapy have
      indicated that visual illusion of functional limb provided by mirror can support healing. By
      means of visual feedback, modified vision and perception is stimulated plasticity the
      premotor cortex and developed re-organization. In the current studies, mirror therapy in
      hemiplegic patients, have been shown that improve the function and reduce the sensitivity of
      the hemi neglect. Gygax et al. have investigated the effects of mirror therapy on upper
      extremity function 10 children with unilateral spastic CP between 6-14 years. Consequently,
      the spontaneous use affected hand, the maximum grip force increase of 15% and is demonstrated
      that improve the upper extremity motor function.
    

Intervention name(s): control group; intervention group
Intervention type(s): Other; Other
Intervention description(s): Children continued their traditional physiotherapy including upper limb exercises in three times a week for 8 week.; Participants allocated to the experimental group completed three times a week, 8-week mirror therapy in addition to traditional physiotherapy . This protocol consisted of mirror therapy with a mirror box.
Other intervention name(s): traditional physiotherapy; mirror therapy in addition to traditional physiotherapy
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: In this type of controlled clinical trials, the same subjects are used as experimental and control groups, ie both the new treatment method and the classical method or the placebo method are applied to the same subjects. The efficacy is applied to the new treatment method and on the other hand the classical method is applied on the same subjects at different times and the results are compared.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: cerebral palsy; mirror therapy; cerebral re-organization; upper extremity; daily life activities; functional motor capacity; motor functions