Mirror Therapy in Stroke

Study Overview
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Brief Summary
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Little is known about mirror therapy and cognitive exercises applied together in patients with stroke by means of telerehabilitation. The aim of this study is to investigate the effects of home-based mirror therapy combined with cognitive exercises on upper extremity functions and cognition in adults with stroke and to compare these effects with mirror therapy alone.

Official Title
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Home-based Mirror Therapy and Cognitive Therapeutic Exercises After Stroke

Conditions
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Stroke, Cognitive Therapy, Telerehabilitation

Intervention / Treatment
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* Other: Mirror Therapy
* Other: Mirror Therapy + Cognitive Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 40 years old and over having had a stroke having unilateral involvement having sufficient communication skills to answer oral and written questions and following instructions 20< points in MMSE Exclusion Criteria: a stroke history under the age of 40 not having a verbal or written communication level that cannot fulfill the study conditions

Ages Eligible for Study
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Minimum Age: 40 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: Mirror Therapy<br>Exercises including mirror therapy will be applied to the participants in the Mirror Therapy group. The mirror will be placed in such a way that the affected extremity of the patient could not be seen behind the mirror and the healthy extremity would be in front of his eyes, the patient will perform the exercises indicated by the physiotherapist with his intact extremity, looking into the mirror. The exercises will be performed in sessions lasting 60 minutes, 3 days a week, over 8 weeks. | Other: Mirror Therapy<br>* Mirror Therapy applied alone<br>|
| Experimental: Mirror+Cognitive Therapy<br>The participants in the Mirror+Cognitive Therapy will be given a cognitive task with the application of mirror therapy. Cognitive tasks with mirror therapy will be applied in sessions lasting 60 minutes, 3 days a week, over 8 weeks. | Other: Mirror Therapy + Cognitive Therapy<br>* Mirror Therapy supported with Cognitive Exercises<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mini-Mental State Examination | The Mini-Mental State Examination (MMSE) is a 30-point test. Higher values mean better performance. | changes after 8 weeks | 
| Fugl-Meyer Upper Extremity Motor Assessment | The Fugl-Meyer Assessment scale is an ordinal scale that has 3 points for each item. A zero score is given for the item if the subject cannot do the task. A score of 1 is given when the task is performed partially and a score of 2 is given when the task is performed fully. The total possible scale score is 226. Higher scores mean better performance. | changes after 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stroke-Specific Quality of Life Scale | Specific Quality Of Life scale (SSQOL) is a patient-centered outcome measure intended to provide an assessment of health-related quality of life specific to patients with stroke. The original test consists of 49 items encompassing 12 domains. Each item is ranked on a 5-point scale, with higher scores indicating better function. | changes after 8 weeks | 
| Beck Depression Scale | The Beck Depression Scale is a 21-item self-report inventory designed to assess the presence and severity in depressive symptoms. Each item is rated on a 4-point Likert-type scale ranging from 0 to 3, based on the severity in the last two weeks. Higher scores indicating worse level of depression. | changes after 8 weeks | 
| Barthel Activity of Daily Living Scale | The Barthel Index (BI) measures the extent to which somebody can function independently and has mobility in their activities of daily living (ADL) i.e. feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, chair transfer, ambulation and stair climbing. Eight factors are rated to produce an overall score on a point scale of 0 to 100. Then, an assignment is given as excellent for 95 to 100 points; good for 84 to 94 points, fair for 65 to 83 points, or poor for less than 65 points, higher scores indicating better function. | changes after 8 weeks | 
| Modified Ashworth Scale | The modified Ashworth scale is a muscle tone assessment scale used to assess the resistance experienced during passive range of motion, which does not require any instrumentation and is quick to perform.This scale grades the muscle tone from 0 (normal) to 4 (severe spasticity). The usage of this scale is easy; however, the results depend on the evaluator. Higher scores indicating sever spasticity. | changes after 8 weeks |