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Bajuaifer S, Grey MJ, Hancock NJ, Chandler E, Pomeroy VM. Maximum tolerable daily dose of mirror movement therapy ankle exercises after stroke: an early phase dose screening study. Physiotherapy 2024; 122:30-39. [PMID: 38237263 DOI: 10.1016/j.physio.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 09/28/2023] [Accepted: 10/29/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND Mirror movement therapy may reduce lower limb motor impairment after stroke. The dose is unknown. OBJECTIVE identify the maximum tolerable dose a day (MTD) of lower limb mirror movement therapy DESIGN: 3 + 3 cohort rule-based, dose escalation/de-escalation study. After undertaking baseline measures participants performed mirror movement therapy for 14 consecutive days. Participants then undertook outcome measures. Cohort One trained for 15 minutes daily. Subsequent cohorts exercised at a dose set according to pre-set rules and the modified Fibonacci sequence. The study stopped when the difference between set doses for consecutive cohorts was 10% or less. SETTING Participants' homes (intervention) and a movement analysis laboratory (measures). PARTICIPANTS Adults discharged from statutory stroke rehabilitation services. INTERVENTION Mirror movement therapy ankle exercises. OUTCOME MEASURES Motricity Index (primary) and bilateral time symmetry from movement onset to peak activation of Tibialis Anterior muscles during standardised sit-to-stand (secondary). RESULTS Five cohorts of three participants were included (n = 15). Mean (SD) age and time after stroke were 61 (9) years and 35 (42) months respectively. Set daily doses for the five cohorts were: 15, 30, 50, 40 then 35 minutes. The set dose for a subsequent cohort (six) would have been 38 minutes thus the difference from cohort five would have been three minutes i.e., 9% different. Therefore, the study stopped CONCLUSION: The identified MTD of lower limb mirror therapy was 35 minutes daily when frequency was set at seven days a week and duration as two weeks. CLINICAL TRIAL REGISTRATION NUMBER NCT04339803 (ClinicalTrials.gov) CONTRIBUTION OF THE PAPER: This early phase study found that the maximum tolerable dose per day (MTD) of mirror movement therapy ankle exercises was 35 minutes when frequency was set at seven days a week and duration as two weeks. The optimal therapeutic dose will therefore be somewhere in the range of 15 (starting dose) to 35 minutes per day. Further dose articulation studies are required to identify the optimal therapeutic dose before use of findings in clinical practice. This study is the first step in that research process.
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Rosero-Herrera J, Acuña-Bravo W. A lower limb rehabilitation platform with mirror therapy, electrical stimulation and virtual reality for people with limited dorsiflexion movement. HARDWAREX 2022; 11:e00285. [PMID: 35509932 PMCID: PMC9058726 DOI: 10.1016/j.ohx.2022.e00285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper presents a low-cost portable system for applying a rehabilitation therapy, based on virtual reality, functional electrical stimulation and a training device. This open-hardware system, intended to support a home-made therapy process in people with reduced dorsiflexion ability, contains three main building blocks: an electromechanical platform, an immersive virtual reality interface and the firmware. The electromechanical training platform is the core of the system, which acts as a gateway interface of sensors-actuators for a closed loop system, through an immersive virtual reality application, the patient closes the loop by acting as the controller by means of a "virtual dummy" preforming in mirror configuration. The platform measures and process the dorsiflexion angle described by both ankles, real-time transmitting the information to the mobile phone virtual application to be presented as a mirror. The onboard microprocessor drives the operation of the electric stimulation interface, which is sent through two channels to both, healthy and affected lower limbs. The platform communicates continuously through a USB bidirectional interface with a personal computer, in which the physician enters the rehabilitation protocol and follows the patient performance. A first case study by using this device has been reported in [1].
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Affiliation(s)
| | - W. Acuña-Bravo
- Departamento de Electrónica, Instrumentación y Control, Facultad de Ingeniería Electrónica y Telecomunicaciones, Universidad del Cauca, Campus Tulcán, Popayán, Colombia
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Cui W, Huang L, Tian Y, Luo H, Chen S, Yang Y, Li Y, Fu J, Yu Q, Xu L. Effect and mechanism of mirror therapy on lower limb rehabilitation after ischemic stroke: A fMRI study. NeuroRehabilitation 2022; 51:65-77. [PMID: 35311718 DOI: 10.3233/nre-210307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mirror therapy has been gradually adopted for lower limb rehabilitation, but its efficacy and neural mechanism are not well understood. OBJECTIVE This study aims to investigate the effect and neural mechanism of mirror therapy on lower limb rehabilitation after ischemic stroke by using resting state functional magnetic resonance imaging (rs-fMRI). METHODS A single-blind and randomized controlled pilot study was conducted. 32 patients with ischemic stroke were included in this study and randomly divided into two groups - the control group (CT, n = 16) and the mirror therapy group (MT, n = 16). Both the CT and MT groups received medication and routine rehabilitation training. In addition, mirror therapy was added to the MT group 5 times a week for 30 minutes each time over a period of 3 weeks. Patients' motor functions, functional connectivity (FC), regional homogeneity (ReHo), and fractional amplitude of low-frequency fluctuations (fALFF) were analyzed both before and immediately after the treatment. RESULTS Patients' motor functions showed significant improvement in both groups compared to those before treatment (p < 0.01). Moreover, the MT group showed significantly better improvement than the CT group after the treatment (p < 0.05). FC, ReHo and fALFF indicated enhanced neuronal activities in motor function-related brain regions in the MT group compared to the CT group. CONCLUSION Mirror therapy promotes the recovery of lower limb motor functions in patients with ischemic stroke. Through the comparative rs-fMRI analysis, it is found that the mirror therapy promotes the functional reorganization of the injured brain.
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Affiliation(s)
- Wei Cui
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Lin Huang
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Yang Tian
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Hong Luo
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Shuang Chen
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Yan Yang
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Yamei Li
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Jing Fu
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Qian Yu
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
| | - Li Xu
- Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China
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Morphological and Functional Changes of the Tibialis Anterior Muscle After Combined Mirror Visual Feedback and Electromyographic Biofeedback in Poststroke Patients: A Randomized Trial. Am J Phys Med Rehabil 2021; 100:766-773. [PMID: 33105154 DOI: 10.1097/phm.0000000000001628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the morphological and functional changes of the tibialis anterior muscle after mirror visual feedback combined with electromyographic biofeedback in poststroke patients. DESIGN A total of 46 poststroke patients were randomly divided into three groups: a mirror visual feedback + electromyographic biofeedback group, a mirror visual feedback group, and a control group. The mirror visual feedback + electromyographic biofeedback group was treated with both mirror visual feedback and electromyographic biofeedback, and the mirror visual feedback group was treated with mirror visual feedback alone. The morphological parameters, including the pennation angle, muscle thickness, and fascicle length, were assessed. RESULTS After 4 wks of treatment, the pennation angle and muscle thickness values were significantly increased in the mirror visual feedback + electromyographic biofeedback and mirror visual feedback groups (P < 0.05). The increase of these values in the mirror visual feedback + electromyographic biofeedback group was significantly greater than that in both metrics in the mirror visual feedback and control groups (P < 0.05), and those in the mirror visual feedback group were greater than those in the control group (P < 0.05). There was no significant difference in the fascicle length value among the three groups as a result of the treatment. After the treatment, the neurological functions were all increased in three groups (P < 0.05). CONCLUSIONS A combination of mirror visual feedback and electromyographic biofeedback seems to be an effective therapy for improving the motor function of the tibialis anterior muscle in poststroke patients.Clinical trial registration number: ChiCTR1800017050.
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Kim E, Meinhold W, Shinohara M, Ueda J. Statistical Inter-stimulus Interval Window Estimation for Transient Neuromodulation via Paired Mechanical and Brain Stimulation. Front Neurorobot 2020; 14:1. [PMID: 32116633 PMCID: PMC7010981 DOI: 10.3389/fnbot.2020.00001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/13/2020] [Indexed: 11/13/2022] Open
Abstract
For achieving motor recovery in individuals with sensorimotor deficits, augmented activation of the appropriate sensorimotor system, and facilitated induction of neural plasticity are essential. An emerging procedure that combines peripheral nerve stimulation and its associative stimulation with central brain stimulation is known to enhance the excitability of the motor cortex. In order to effectively apply this paired stimulation technique, timing between central and peripheral stimuli must be individually adjusted. There is a small range of effective timings between two stimuli, or the inter-stimulus interval window (ISI-W). Properties of ISI-W from neuromodulation in response to mechanical stimulation (Mstim) of muscles have been understudied because of the absence of a versatile and reliable mechanical stimulator. This paper adopted a combination of transcranial magnetic stimulation (TMS) and Mstim by using a high-precision robotic mechanical stimulator. A pneumatically operated robotic tendon tapping device was applied. A low-friction linear cylinder achieved high stimulation precision in time and low electromagnetic artifacts in physiological measurements. This paper describes a procedure to effectively estimate an individual ISI-W from the transiently enhanced motor evoked potential (MEP) with a reduced number of paired Mstim and sub-threshold TMS trials by applying statistical sampling and regression technique. This paper applied a total of four parametric and non-parametric statistical regression methods for ISI-W estimation. The developed procedure helps to reduce time for individually adjusting effective ISI, reducing physical burden on the subject.
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Affiliation(s)
- Euisun Kim
- Bio-Robotics and Human Modeling Laboratory, G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Waiman Meinhold
- Bio-Robotics and Human Modeling Laboratory, G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Minoru Shinohara
- Human Neuromuscular Physiology Laboratory, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Jun Ueda
- Bio-Robotics and Human Modeling Laboratory, G.W.W. School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
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The effects of electromyography-triggered neuromuscular electrical stimulation plus tilt sensor functional electrical stimulation training on gait performance in patients with subacute stroke: a randomized controlled pilot trial. Int J Rehabil Res 2019; 42:358-364. [DOI: 10.1097/mrr.0000000000000371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mitsutake T, Sakamoto M, Koyama S, Matsuda K, Okita M, Horikawa E. Effects of the combination therapy of tilt sensor functional electrical stimulation and integrated volitional control electrical stimulation on brain activity during the subacute phase following stroke: a feasibility study. J Phys Ther Sci 2018; 30:1412-1416. [PMID: 30568326 PMCID: PMC6279698 DOI: 10.1589/jpts.30.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/12/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate whether the combination of integrated
volitional control functional electrical stimulation and tilt sensor functional electrical
stimulation training affected brain activation during the subacute phase following a
stroke. [Participant and Methods] The patient was a 60-year-old male with right
hemiparesis, secondary to stroke in the left thalamus. Conventional intervention was
performed for 60 minutes per day during the first two weeks of treatment (the control
condition). Functional electrical stimulation intervention, including integrated
volitional control functional electrical stimulation and tilt sensor functional electrical
stimulation training, was then performed for 60 minutes per day for two weeks (the
experimental condition). These sessions were repeated four times. Brain activity was
measured during voluntary right ankle dorsiflexion in both sessions, using functional
magnetic resonance imaging. Brain activity measurements were obtained a total of eight
times every two weeks (34, 48, 62, 76, 90, 104, 118, and 132 days following the stroke).
[Results] There was a significantly higher level of activation in the bilateral cerebellum
and the left side of the supplementary motor area in the experimental condition than in
the control condition. [Conclusion] The present study demonstrates that the combination of
integrated volitional control functional.
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Affiliation(s)
- Tsubasa Mitsutake
- Department of Rehabilitation, Shiroishi Kyoritsu Hospital: 1296 Fukuta, Shiroishi, Kishima, Saga 849-1112, Japan.,Research and Education Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Japan
| | - Maiko Sakamoto
- Research and Education Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Japan
| | - Soichiro Koyama
- Faculty of Rehabilitation, School of Health Science, Fujita Health University, Japan
| | - Kensuke Matsuda
- Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Japan
| | | | - Etsuo Horikawa
- Research and Education Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Japan
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Louie DR, Lim SB, Eng JJ. The Efficacy of Lower Extremity Mirror Therapy for Improving Balance, Gait, and Motor Function Poststroke: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis 2018; 28:107-120. [PMID: 30314760 DOI: 10.1016/j.jstrokecerebrovasdis.2018.09.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 09/09/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Mirror therapy is less commonly used to target the lower extremity after stroke to improve outcomes but is simple to perform. This review and meta-analysis aimed to evaluate the efficacy of lower extremity mirror therapy in improving balance, gait, and motor function for individuals with stroke. METHODS PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and PsychINFO were searched from inception to May 2018 for randomized controlled trials (RCTs) comparing lower extremity mirror therapy to a control intervention for people with stroke. Pooled effects were determined by separate meta-analyses of gait speed, mobility, balance, and motor recovery. RESULTS Seventeen RCTs involving 633 participants were included. Thirteen studies reported a significant between-group difference favoring mirror therapy in at least one lower extremity outcome. In a meta-analysis of 6 trials that reported change in gait speed, a large beneficial effect was observed following mirror therapy training (standardized mean differences [SMD] = 1.04 [95% confidence interval [CI] = .43, 1.66], I2 = 73%, and P < .001). Lower extremity mirror therapy also had a positive effect on mobility (5 studies, SMD = .46 [95% CI = .01, .90], I2 = 43%, and P = .05) and motor recovery (7 studies, SMD = .47 [95% CI = .21, .74], I2 = 0%, and P < .001). A significant pooled effect was not found for balance capacity. CONCLUSIONS Mirror therapy for the lower extremity has a large effect for gait speed improvement. This review also found a small positive effect of mirror therapy for mobility and lower extremity motor recovery after stroke.
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Affiliation(s)
- Dennis R Louie
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Canada; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Canada
| | - Shannon B Lim
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Canada; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Canada
| | - Janice J Eng
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Canada; Department of Physical Therapy, University of British Columbia, Canada.
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Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev 2018; 7:CD008449. [PMID: 29993119 PMCID: PMC6513639 DOI: 10.1002/14651858.cd008449.pub3] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Mirror therapy is used to improve motor function after stroke. During mirror therapy, a mirror is placed in the person's midsagittal plane, thus reflecting movements of the non-paretic side as if it were the affected side. OBJECTIVES To summarise the effectiveness of mirror therapy compared with no treatment, placebo or sham therapy, or other treatments for improving motor function and motor impairment after stroke. We also aimed to assess the effects of mirror therapy on activities of daily living, pain, and visuospatial neglect. SEARCH METHODS We searched the Cochrane Stroke Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, AMED, PsycINFO and PEDro (last searched 16 August 2017). We also handsearched relevant conference proceedings, trials and research registers, checked reference lists, and contacted trialists, researchers and experts in our field of study. SELECTION CRITERIA We included randomised controlled trials (RCTs) and randomised cross-over trials comparing mirror therapy with any control intervention for people after stroke. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials based on the inclusion criteria, documented the methodological quality, assessed risks of bias in the included studies, and extracted data. We assessed the quality of the evidence using the GRADE approach. We analysed the results as standardised mean differences (SMDs) or mean differences (MDs) for continuous variables, and as odds ratios (ORs) for dichotomous variables. MAIN RESULTS We included 62 studies with a total of 1982 participants that compared mirror therapy with other interventions. Of these, 57 were randomised controlled trials and five randomised cross-over trials. Participants had a mean age of 59 years (30 to 73 years). Mirror therapy was provided three to seven times a week, between 15 and 60 minutes for each session for two to eight weeks (on average five times a week, 30 minutes a session for four weeks).When compared with all other interventions, we found moderate-quality evidence that mirror therapy has a significant positive effect on motor function (SMD 0.47, 95% CI 0.27 to 0.67; 1173 participants; 36 studies) and motor impairment (SMD 0.49, 95% CI 0.32 to 0.66; 1292 participants; 39 studies). However, effects on motor function are influenced by the type of control intervention. Additionally, based on moderate-quality evidence, mirror therapy may improve activities of daily living (SMD 0.48, 95% CI 0.30 to 0.65; 622 participants; 19 studies). We found low-quality evidence for a significant positive effect on pain (SMD -0.89, 95% CI -1.67 to -0.11; 248 participants; 6 studies) and no clear effect for improving visuospatial neglect (SMD 1.06, 95% CI -0.10 to 2.23; 175 participants; 5 studies). No adverse effects were reported. AUTHORS' CONCLUSIONS The results indicate evidence for the effectiveness of mirror therapy for improving upper extremity motor function, motor impairment, activities of daily living, and pain, at least as an adjunct to conventional rehabilitation for people after stroke. Major limitations are small sample sizes and lack of reporting of methodological details, resulting in uncertain evidence quality.
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Affiliation(s)
- Holm Thieme
- Erste Europäische Schule für Physiotherapie, Ergotherapie und Logopädie, Klinik Bavaria KreischaKreischa, SachsenGermany
- Martin Luther University Halle‐WittenbergInstitute for Health and Nursing Science, German Center for Evidence‐based NursingHalle/SaaleGermany
- Fakultät Soziale Arbeit und GesundheitHAWK Hochschule für angewandte Wissenschaft und KunstHildesheimGermany31134
| | - Nadine Morkisch
- Charité ‐ University Medicine BerlinCenter for Stroke Research BerlinCharitéplatz 1BerlinGermany0117
- MEDIAN Klinik Berlin‐KladowKladower Damm 223BerlinGermany14089
| | - Jan Mehrholz
- Technical University DresdenDepartment of Public Health, Dresden Medical SchoolFetscherstr. 74DresdenGermany01307
| | - Marcus Pohl
- Helios Klinik Schloss PulsnitzNeurological RehabilitationWittgensteiner Str. 1PulsnitzSaxonyGermany01896
| | - Johann Behrens
- Martin Luther University Halle‐WittenbergInstitute for Health and Nursing Science, German Center for Evidence‐based NursingHalle/SaaleGermany
| | - Bernhard Borgetto
- Fakultät Soziale Arbeit und GesundheitHAWK Hochschule für angewandte Wissenschaft und KunstHildesheimGermany31134
| | - Christian Dohle
- Charité ‐ University Medicine BerlinCenter for Stroke Research BerlinCharitéplatz 1BerlinGermany0117
- MEDIAN Klinik Berlin‐KladowKladower Damm 223BerlinGermany14089
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Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Gait Posture 2018; 63:208-220. [PMID: 29775908 DOI: 10.1016/j.gaitpost.2018.05.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/07/2018] [Accepted: 05/11/2018] [Indexed: 02/02/2023]
Abstract
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.
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Affiliation(s)
- P Broderick
- Institute of Technology Sligo, Sligo, Ireland.
| | - F Horgan
- Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - C Blake
- University College Dublin, Dublin, Ireland.
| | | | - D Simpson
- Institute of Technology Sligo, Sligo, Ireland.
| | - K Monaghan
- Institute of Technology Sligo, Sligo, Ireland.
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Sun X, Gao Q, Dou H, Tang S. Which is better in the rehabilitation of stroke patients, core stability exercises or conventional exercises? J Phys Ther Sci 2016; 28:1131-3. [PMID: 27190440 PMCID: PMC4868200 DOI: 10.1589/jpts.28.1131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 12/22/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to determine which is better in the rehabilitation of
stroke patients, core stability exercises or conventional exercises. [Subjects and
Methods] Forty participants with hemiplegia were recruited in the Department of Neurology
of Yidu Central Hospital of Weifang between January 2014 and February 2015 and randomly
divided into either an experimental or control group. The patients in the control group
performed conventional exercises for six weeks, and those in the experiment group
performed core stability exercises for six weeks. The outcomes were evaluated using
Modified Barthel Index and Berg Balance Scale. [Results] After treatment, the Modified
Barthel Index and Berg Balance Scale were significantly increased in both groups when
compared with the baseline. The Modified Barthel Index was significantly lower in the
control group compared with the experimental group. The Berg Balance Scale scores in the
control group were relatively lower than those in the experimental group, but there was no
significant difference between the two groups. [Conclusion] Core stability exercises have
a better effect on patients with hemiplegia than conventional exercises.
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Affiliation(s)
- Xibo Sun
- Department of Neurology, Yidu Central Hospital of Weifang, China
| | - Qian Gao
- Functional Inspection Department, Yidu Central Hospital of Weifang, China
| | - Honglei Dou
- Department of Orthopaedics, Yidu Central Hospital of Weifang, China
| | - Shujie Tang
- Department of Traditional Chinese Medicine, Medical School, Jinan University, China
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