Effect of Mirror Therapy on Lower Extremity Motor Control and Gait in Patients With Stroke

Study Overview
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Brief Summary
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Mirror therapy may be an effective intervention in increasing motor control and gait performance in patients with stroke.

Detailed Description
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Using a mirrored image of the uninvolved extremity superimposed upon the involved extremity during exercise may facilitate improved motor control in patients after stroke.

Official Title
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Effect of Mirror Therapy on Lower Extremity Motor Control and Gait in Patients With Stroke

Conditions
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Stroke

Intervention / Treatment
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* Other: Traditional Physical Therapy
* Other: Physical Therapy plus Mirror Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: lower extremity Brunnstrom stage 2, lower extremity modified ashworth < 3, has the ability to follow 3-step command in English, has only unilateral involvement. Exclusion Criteria: lower extremity Brunnstrom stage 1, lower extremity modified ashworth 3 or higher, history of prior stroke, Passive Range of Motion limitation of hip and or knee flexion < 90, has visual deficits which prevent participation.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Traditional Physical Therapy<br>The control group will receive traditional physical therapy interventions directed at neuromuscular rehabilitation. | Other: Traditional Physical Therapy<br>* Traditional physical therapy includes, but is not limited to, therapeutic exercise, functional mobility training, pre-gait and gait activities, electrotherapeutic modalities, and education.<br>|
| Experimental: Physical Therapy plus Mirror Therapy<br>The mirror therapy will entail 15 minutes of exercises for the lower extremities focusing on ankle dorsiflexion, knee flexion, and hip flexion. | Other: Physical Therapy plus Mirror Therapy<br>* The treatment group will receive traditional physical therapy intervention as described in the control group with the addition of mirror therapy. The participant will attempt to perform the flexion exercises with both lower extremities. The patient will be blinded to the affected lower extremity with a mirror, and will be looking at the image of the unaffected lower extremity superimposed on the affected lower extremity as he or she performs the activities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional Independence Measure - Locomotor Score | The Functional Independence Measure (FIM)assesses level of disability and measures progress toward independence with rehabilitational intervention. The tool consists of 18 items. Only the the locomotor score was used to assess gait ability in this study. The locomotor score ranges from 1 - 7 with a higher score indicating a higher level of functional independence. | measured at admission and discharge from rehab estimated length of stay 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Timed Up and Go | The Timed Up and Go (TUG) is used to assess balance and gait, and to estimate fall risks in patients with deficits. The participant rises from a seated position in a chair, walks 3 meters, turns around, returns to the chair, and sits down. The test is measured in seconds, with a lower number indicating a higher level of independence and the least risk for falls. | Measured at admission and discharge with estimated length of stay 14 days | 
| Stroke Rehabilitation Assessment of Movement | The Stroke Rehabilitation Assessment of Movement (STREAM)is designed to measure mobility and motor ability after stroke. There are three subscales with 10 items each assessing the upper extremity, lower extremity, and basic mobility. Only the lower extremity and basic mobility items were used in this study. The lower extremity scores ranged from 0 - 18 with higher scores indicating a higher level of motor control. The basic mobility scores ranged from 0 - 30 with high numbers indicating a higher level of functional mobility. | measured at admission and discharge with estimated length of stay 14 days |