Effects of Early Sensory Reeducation Programs Using Mirror Therapy for Patients With Peripheral Nerve Injuries

Study Overview
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Brief Summary
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This study evaluated the effects of an integrated program of touch-observation and task-based mirror therapy on sensorimotor function in nerve injury patients. Before the return of protective sense (Value of Semmes-Weinstein monofilament test > 4.31), half of the participants received 15 minutes of mirror therapy program, followed by 20 minutes of regular hand therapy and 20 minutes of physiotherapy.While the other half received 15 minutes protective sensory reeducation programs, 20 minutes of regular hand therapy and 20 minutes of physiotherapy in each treatment session. Once the patients had regained the protective sense (Value of Semmes-Weinstein monofilament test < 4.31), the discriminative sensory reeducation program was started for the participants in both groups. The hypothesis was that using the mirror therapy for sensorimotor reeducation in the early phase after nerve repair would yield better results with regard to the returning of sensation, sensorimotor control ability and hand function than using a classical reeducation program alone.

Official Title
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A Touch-Observation and Task-based Mirror Therapy Protocol (MTPTOT) to Improve Sensorimotor Control and Functional Capability of Hands for Patients With Peripheral Nerve Injury

Conditions
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Sensation Disorders, Motor Deficit, Rehabilitation

Intervention / Treatment
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* Behavioral: Sensorimotor reeducation programs


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: median or ulnar nerve injury, a combination of nerve and tendon or vascular injury, injury sites between the level of mid-palm and elbow, and the protective sensation of the hand is lacking or impaired. Exclusion Criteria: patients with deficits in cognition or language comprehension, as well as severe limitations in the range of motion of the upper limbs.

Ages Eligible for Study
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Minimum Age: 20 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 |
| --- | --- |
| Experimental: Early sensorimotor reeducation intervention<br>The experimental group received 15 minutes of touch-observation and task-based mirror therapy program, followed by 20 minutes of regular hand therapy and 20 minutes of physiotherapy in each treatment session before the returning of the touch of a Semmes-Weinstein monofilament marked 4.31. Once the patients had regained the protective sense (SWM < 4.31), the mirror therapy program was replaced with a discriminative sensory reeducation program. Treatment duration was 12 weeks, at a frequency of three sessions per week. | Behavioral: Sensorimotor reeducation programs<br> <br> |
| Active Comparator: Traditional sensorimotor reeducation intervention<br>The control group received received 15 minutes traditional sensory reeducation program, 20 minutes of regular hand therapy and 20 minutes of physiotherapy in each treatment session before the returning of the touch of a Semmes-Weinstein monofilament marked 4.31. Once the patients had regained the protective sense (SWM < 4.31), the protective sensory reeducation program was replaced with a discriminative sensory reeducation program. Treatment duration was 12 weeks, at a frequency of three sessions per week. | Behavioral: Sensorimotor reeducation programs<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline result of Semmes-Weinstein monofilament (SWM) test at 12 weeks and 24 weeks |  | baseline, 12 weeks and 24 weeks | 
| Change from baseline result of Purdue pegboard test at 12 weeks and 24 weeks |  | baseline, 12 weeks and 24 weeks | 
| Change from baseline result of Minnesota manual dexterity test at 12 weeks and 24 weeks |  | baseline, 12 weeks and 24 weeks | 
| Change from baseline result of Pinch-holding-up-activity (PHUA) test at 12 weeks and 24 weeks |  | baseline, 12 weeks and 24 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline result of Static two-point discrimination (S2PD) test at 12 weeks and 24 weeks |  | baseline, 12 weeks and 24 weeks |