Effects of Mirror Therapy and Bilateral Arm Training on Hemiparetic Upper Extremity in Patients With Chronic Stroke
Condition: Stroke; Hemiplegia
MeSH terms: Stroke; Hemiplegia
Study type: Interventional

Summary: 
      The aim of this study included (1) to compare the effectiveness of mirror therapy (MT) and
      bimanual arm training (BAT) in improving motor and functional performance of hemiplegic upper
      extremity for adults with chronic stroke; (2) to examine whether recruitment of the mirror
      neurons, as reflected in mu rhythm suppression, mediates recognition of the mirror illusion
      in pre/post MT, as compared to BAT without a mirror in clients with chronic stroke, as
      compared to healthy participants.
    

Detailed description: 
      Mirror Therapy (MT) appeared to have beneficial effects on the recovery of distal function of
      the hemiplegic hand in the evidence recently, however, it is not known whether the
      incongruent visual feedback induced by mirror in bilateral arm training (BAT) is beneficial
      to the motor performance of upper extremity than without the mirror in patients with chronic
      stroke. This study aimed to compare the effectiveness of MT and bimanual arm training (BAT)
      in improving motor and functional performance of hemiplegic upper extremity for adults with
      chronic stroke. Participants with chronic stroke were recruited by convenience sampling from
      a convalescent hospital and self-help groups in the community in Hong Kong. Participants were
      randomly assigned to the MT group or BAT group and participated in a 6-week upper limb
      training programme which consisted of two 45-minute training sessions per week. Both kinds of
      training were equivalent to each other except that there was a mirror used in the MT group.
      Main outcome measures were upper extremity motor and functional tests, and grip strength.
      Participants were evaluated at baseline, post-treatment and 3-month follow-up. EEG was
      assessed before and after the training in a group of stroke patients and healthy controls, in
      order to evaluate the recruitment of the mirror neurons, as reflected in mu rhythm
      suppression.
    

Intervention name(s): Mirror Therapy; Bilateral arm training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Patients performed customized bimanual upper limb exercises with graded level of difficulty based on the patient's individual levels of upper limb functioning according to the 7 levels of the FTHUE and each level consisted of 5 standardized table-top tasks. The patients practiced the movements with the unaffected hand (including the shoulder, elbow, wrist, and hand). While watching the reflection of the unaffected hand in the mirror, the patient was then asked to moving the affected hand at the same time to synchronize the movement with the reflection of the unaffected hand. If the patient was unable to move the hand, a therapist would passively assist the movement of the affected hand so as to synchronize it with the reflection of the unaffected hand.; Patients performed customized bimanual upper limb exercises with graded level of difficulty based on the patient's individual levels of upper limb functioning according to the 7 levels of the FTHUE and each level consisted of 5 standardized table-top tasks, but without a mirror. The patients can take a direct view of their paretic hand.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stroke; Mirror therapy; Bilateral arm training; Upper limb function