Mirror Therapy and CIMT in Chronic Stroke Patients
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The aim of this research is to find and compare the effect of mirror therapy and constrained
      induced movement therapy in upper limb rehabilitation among chronic stroke patient .Study
      conducted in THQ Hospital Depalpur. The sample size was 36. Patients were divided into two
      groups. In group-A patients were treated with mirror therapy and in group-B patients were
      treated with constrained induced movement therapy. Both therapy sessions lasting for 60
      minutes for total 1 hour in a day, 5 times a week and for consecutive 3 weeks in a month.
      Sessions consist of total 20 min of passive mobilization to both groups, 30 min session for
      MMT to 1 group, 30 min session to CIMT (task specific) to another group, and 10 minutes
      standard ADL activities. The outcome was calculated with FMA-UE and modified Ashworth scale.
      Data was analyzed by SPSS 22.
    

Detailed description: 
      Worldwide stroke affects mostly aged population and thus leads to morbidity and mortality.

      According to world health organization stroke causes second most common cases of death and a
      leading cause of morbidity in adults. Most developed countries are more affected with stroke
      as compared to developing region around the world. Based on WHO record, estimated annual
      death rates with stroke was 5.5 million. For optimal functioning, Brain requires sufficient
      supply of blood and for this carotid arteries are responsible for supplying oxygen rich blood
      to different areas of the brain. As an individual breathes, the brain consumes 20% of oxygen,
      which allows it to work efficiently. As in the case of a stroke, brain cells die quickly when
      there is a blockage or obstruction of oxygen to the brain by impeded blood flow. Blood
      plaques or clots disrupts oxygen rich supply to the brain in ischemic stroke leads to brain
      cell death. Whereas, sudden rupturing of blood vessels leads to cell death in hemorrhagic
      stoke. Most studies showed that task specific motor programs an repetition of movements on
      both upper and lower limbs are more effective interventions14. Various other treatment
      protocols are also used for improving limb functions, like visual feedback training,
      assistive robotic training, Functional Electrical Stimulator (FES) and Constrained Induced
      Movement Therapy (CIMT). These therapies help in improving motor performance from the
      affected side of stroke patients. Uni-manual, high intensity training known as Constrained
      Induced Movement Therapy or forced use is reported as an effective treatment for training the
      motor cortex areas. Task specific or bi-manual programs with rhythmic auditory clues were
      also included in this training to improve motor functions. Researcher conducted a latest
      study in 2019 by random sampling method to find the effect of mirror therapy for upper limb
      rehabilitation. They allocate the participants randomly into three groups based on movement
      mirror therapy (MMT), task specific mirror therapy (TMT) and conventional therapy (CT). The
      session consists of 30 minutes a day, 5 days in a week and for total 4 weeks. Performance was
      measured by FMA-UE, Wolf motor assessment and modified Ash worth scale. The results were the
      same for both MMT and TMT for upper limb rehabilitation. In 2018 Yumi Ju et al. Conducted
      study in the Korea to examine the effectiveness of mirror therapy and constrained induced
      movement therapy for the rehabilitation of the upper extremity for daily life activities. 28
      subjects were randomly placed to a weekly session of 5 days and for consecutive 3 weeks.
      Performance was measured by Manual Function Test (MFT) and Modified Barthel Index(BI) to find
      the factor which is affecting the activities of daily livings. They concluded that patients
      actively participate in activities of daily livings by actively moving their affected.
      Previous researches based on the effectiveness of mirror therapy and constrained induced
      movement therapy alone or combined with other rehabilitative therapies for improving upper
      limb rehabilitation in different patients having neurological impairments. Their outcomes
      were evaluated on different outcome measurement tools and their were significant improvement
      in patients functional independence and had good quality of life.
    

Intervention name(s): Mirror therapy; CIMT group
Intervention type(s): Other; Other
Intervention description(s): Session consist of total 1hour,20 min of passive mobilization, 30 minutes for Movement mirror therapy,10 minutes standard ADL activities 5 times a week and for consecutive 3 weeks in a month.; Session consist of total 1hour ,20 min of passive mobilization, 30 min session to CIMT and 10 minutes standard ADL activities 5 times a week and for consecutive 3 weeks in a month.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Mirror therapy ,Constrained induced movement therapy, stroke