Effects of mirror therapy integrated with task-oriented exercise on the balance function of patients with poststroke hemiparesis: a randomized-controlled pilot trial

A Solution for the Remote Care of Frail Elderly Individuals via Exergames

Internet of Things (IoT) solutions are a concrete answer to many needs in the healthcare framework since they enable remote support for patients and foster continuity of care. Currently, frail elderly people are among end users who most need and would benefit from IoT solutions from both a social and a healthcare point of view. Indeed, IoT technologies can provide a set of services to monitor the healthcare of the elderly or support them in order to reduce the risk of injuries, and preserve their motor and cognitive abilities. The main feature of IoT solutions for the elderly population is ease of use. Indeed, to fully exploit the potential of an IoT solution, patients should be able to autonomously deal with it. The remote-monitoring validation engineering system (ReMoVES) described here is an IoT solution that caters to the specific needs of frail elderly individuals. Its architecture was designed for use at rehabilitation centers and at patients' homes. The system is user-friendly and comfortably usable by persons who are not familiar with technology. In addition, exergames enhance patient engagement in order to curb therapy abandonment. Along with the technical presentation of the solution, a real-life scenario application is described referring to sit-to-stand activity.

EFFECT OF MOTOR IMAGERY TRAINING IN COMBINATION WITH ELECTROMYOGRAPHY-TRIGGERED ELECTRICAL STIMULATION IN STROKE WITH HEMIPLEGIA PATIENTS: A RANDOMIZED CONTROLLED STUDY

Recently, motor imagery training combined with electromyography-triggered electrical stimulation (MIT EMG-ES) has been reported as a remedial treatment for stroke patients. However, the clinical evidence of the effect is still lacking. To investigate the effect of MIT EMG-ES on lower extremities and activities of daily of living (ADL) in patients with stroke, the participants were randomly assigned to an experimental group ([Formula: see text]) or control group ([Formula: see text]). The experimental group underwent MIT EMG-ES, whereas the control group performed underwent motor imagery training. In addition, both groups received the same conventional rehabilitation therapy. All participants underwent treatment for 30[Formula: see text]min a day, 5 sessions per week, for 4 weeks. Lower extremities function was measured by the Fugl–Meyer Assessment Lower Extremity (FMA-LE), Timed Up-and-Go (TUG) test and 10 m Walk (10[Formula: see text]MW) test. ADL were measured by the Korea version of the Modified Barthel Index (K-MBI). The experimental group except for the FMA-LE group showed more improvement in TUG and 10[Formula: see text]MW test scores than the control group ([Formula: see text]). The effect size showed FMA-LE, TUG, and 10[Formula: see text]MW test (0.7, 1.0, 0.7, respectively). However, there was no statistically significant difference between the two groups in K-MBI ([Formula: see text]). Our findings suggest that MIT EMG-ES may be a novel treatment for lower extremities function in patients with stroke better than MIT alone.

Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis

BACKGROUND

Mirror therapy has been proposed as an effective intervention for lower limb rehabilitation post stroke.

RESEARCH QUESTION

This systematic review with meta-analysis examined if lower limb mirror therapy improved the primary outcome measures of muscle tone and motor function and the secondary outcome measures balance characteristics, functional ambulation, walking velocity, passive range of motion (PROM) for ankle dorsiflexion and gait characteristics in patients with stroke compared to other interventions.

METHODS

Standardised mean differences (SMD) and mean differences (MD) were used to assess the effect of mirror therapy on lower limb functioning.

RESULTS

Nine studies were included in the review. Among the primary outcome measures there was evidence of a significant effect of mirror therapy on motor function compared with sham and non-sham interventions (SMD 0.54; 95% CI 0.24-0.93). Furthermore, among the secondary outcome measures there was evidence of a significant effect of mirror therapy for balance capacity (SMD -0.55; 95% CI -1.01 to -0.10), walking velocity (SMD 0.71; 95% CI 0.35-1.07), PROM for ankle dorsiflexion (SMD 1.20; 95% CI 0.71-1.69) and step length (SMD 0.56; 95% CI -0.00 to 1.12).

SIGNIFICANCE

The results indicate that using mirror therapy for the treatment of certain lower limb deficits in patients with stroke may have a positive effect. Although results are somewhat positive, overly favourable interpretation is cautioned due to methodological issues concerning included studies.

The effects of action observation training and mirror therapy on gait and balance in stroke patients

[Purpose] The aim of this study was to evaluate the effects of action observation training and mirror therapy to improve on balance and gait function of stroke patients. [Subjects and Methods] The participants were randomly allocated to one of three groups: The action observation training with activity group practiced additional action observation training with activity for three 30-minute session for six weeks (n=12). The mirror therapy with activity group practiced additional mirror therapy with activity for three 30-minute sessions for six weeks (n=11). The only action observation training group practiced additional action observation training for three 30-minute sessions for weeks (n=12). All groups received conventional therapy for five 60-minute sessions over a six-week period. [Results] There were significant improvements in balance and gait function. The action observation training with activity group significantly improved subjects’ static balance. The action observation training with activity group and the mirror therapy with activity group significantly improved subjects’ gait ability. [Conclusion] The activation of mirror neurons combined with a conventional stroke physiotherapy program enhances lower-extremity motor recovery and motor functioning in stroke patients.