Synergic effect of the combination of mirror therapy and electrical stimulation for lower extremity motor function recovery in stroke survivors: a meta-analysis of randomized controlled trials

Stroke Recovery Is a Journey: Prediction and Potentials of Motor Recovery after a Stroke from a Practical Perspective

Stroke recovery is a journey. Stroke survivors can face many consequences that may last the rest of their lives. Assessment of initial impairments allows reasonable prediction of biological spontaneous recovery at 3 to 6 months for a majority of survivors. In real-world clinical practice, stroke survivors continue to improve their motor function beyond the spontaneous recovery period, but management plans for maximal recovery are not well understood. A model within the international classification of functioning (ICF) theoretical framework is proposed to systematically identify opportunities and potential barriers to maximize and realize the potentials of functional recovery from the acute to chronic stages and to maintain their function in the chronic stages. Health conditions of individuals, medical and neurological complications can be optimized under the care of specialized physicians. This permits stroke survivors to participate in various therapeutic interventions. Sufficient doses of appropriate interventions at the right time is critical for stroke motor rehabilitation. It is important to highlight that combining interventions is likely to yield better clinical outcomes. Caregivers, including family members, can assist and facilitate targeted therapeutic exercises for these individuals and can help stroke survivors comply with medical plans (medications, visits), and provide emotional support. With health optimization, comprehensive rehabilitation, support from family and caregivers and a commitment to a healthy lifestyle, many stroke survivors can overcome barriers and achieve potentials of maximum recovery and maintain their motor function in chronic stages. This ICF recovery model is likely to provide a guidance through the journey to best achieve stroke recovery potentials.

Re-evaluation of Mirror Visual Feedback Therapy for a Systematic Evaluation/Meta-analysis of Physical Function Re-education After Stroke

OBJECTIVE

The aim of the study is to re-evaluate the methodological quality and quality of evidence for a systematic evaluation/meta-analysis of the effect of mirror visual feedback therapy on physical function re-education after stroke.

METHODS

Systematic evaluations/meta-analyses of mirror visual feedback therapy on physical function re-education after stroke were searched in the China Knowledge Network database, Wanfang database, Vipers database, China Biomedical Literature database, PubMed, Web of Science, and Embase using a computer, and the search time frame was up to January 2022. Methodological quality and quality of evidence ratings of the included studies were determined using the AMSTAR2 scale and GRADE classification by two authors.

RESULTS

Seventeen publications were included. The evaluation with the AMSTAR2 scale showed that one study had an intermediate quality rating, five had a low-quality rating, and the remaining 11 were all very low quality. The GRADE scale showed 93 outcome indicators, of which 6 were intermediate, 23 were low grades, and the rest were very low grades, with low overall quality.

CONCLUSIONS

Mirror visual feedback therapy is efficacious for physical function re-education after stroke and promotes recovery from physical dysfunction, but the methodological quality and quality of evidence from the related systematic evaluations/meta-analyses are low.

Using Mirror Therapy to Optimize the Efficacy of Balance Programs for Older Adults With Poststroke Balance Impairment

PURPOSE

Poststroke rehabilitation is an inevitable element of the treatment for stroke survivors. This study aimed to investigate the effect of balance training with mirror therapy in older adults with poststroke balance impairment.

DESIGN/METHODS

The study adopted a two-arm randomized clinical trial and included 38 older adults with poststroke balance impairment. The intervention group received balance exercises with mirror therapy, whereas the control group received the same balance exercises without mirror therapy (a nonreflective plate was used instead). The patient outcome, the balance score, was measured using the Berg Balance Scale. Analysis of covariance was used for statistical analysis.

RESULTS

Results showed that balance exercises combined with mirror therapy were significantly more effective than balance exercises without mirror therapy in improving balance in the stroke survivors (p < .001).

CONCLUSION

Mirror therapy combined with regular balance exercises is an effective and practical method for enhancing balance in older adults suffering from balance impairment.

CLINICAL RELEVANCE

Balance training combined with containing mirror therapy may be included in the rehabilitation programs of older adults with poststroke balance impairment.