1
|
Stonsaovapak C, Koonalinthip N, Kitisomprayoonkul W. Efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions: A systematic review and meta-analysis. PM R 2024. [PMID: 39051506 DOI: 10.1002/pmrj.13239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/05/2024] [Accepted: 05/16/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis is to assess the efficacy of mirror neuron system-based therapy for managing pain and improving motor and upper limb function in patients with upper limb orthopedic conditions. LITERATURE SURVEY Systematic bibliographical searches of the PubMed, SCOPUS, and CENTRAL registries and databases up to September 2023 were conducted to find randomized controlled trials (RCTs) assessing the efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions. METHODOLOGY Two reviewers assessed the RCTs using a Cochrane risk-of-bias tool and extracted data from studies with similar outcome measures in the domains of pain, motor function, or functional score, which were pooled into meta-analyses. SYNTHESIS The review included 13 studies to compare the efficacy of mirror neuron system-based therapy with that of conventional rehabilitation programs. The therapy reduced pain intensity (mean difference [MD] 2.04, 95% confidence interval [CI] 1.46-2.63) and kinesiophobia (MD 8.43, 95% CI 6.98 to 9.88), and increased grip strength (MD 1.86, 95% CI 0.28-3.45). The therapy also improved upper limb functional outcomes as assessed by the 30-item Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score (MD 13.52, 95% CI 10.63-16.41). However, the outcomes as assessed by the 11-item QuickDASH questionnaire and the Shoulder Pain and Disability Index (SPADI) were not superior to conventional rehabilitation. CONCLUSIONS Mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions may reduce pain intensity and kinesophobia, and improve grip strength and DASH scores compared with conventional rehabilitation programs. However, this interpretation is limited by the heterogeneity and various quality of the RCTs included in our meta-analysis.
Collapse
Affiliation(s)
- Chernkhuan Stonsaovapak
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nantawan Koonalinthip
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wasuwat Kitisomprayoonkul
- Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
2
|
Muñoz-Gómez E, Aguilar-Rodríguez M, Mollà-Casanova S, Sempere-Rubio N, Inglés M, Serra-Añó P. A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome. J Hand Ther 2024:S0894-1130(24)00008-5. [PMID: 38458950 DOI: 10.1016/j.jht.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/07/2024] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS). PURPOSE To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS. STUDY DESIGN Randomized clinical trial. METHODS Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2). RESULTS At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively). DISCUSSION MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles. CONCLUSIONS MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.
Collapse
Affiliation(s)
- Elena Muñoz-Gómez
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Sara Mollà-Casanova
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Nuria Sempere-Rubio
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Inglés
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pilar Serra-Añó
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| |
Collapse
|
3
|
Yalçın G, Mülkoğlu C, Gülmez S, Genç H. The effect of mirror therapy in the rehabilitation of flexor tendon injuries after primary surgical repair. HAND SURGERY & REHABILITATION 2024; 43:101612. [PMID: 37918714 DOI: 10.1016/j.hansur.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of mirror therapy and to provide a clinical basis for better functional recovery in the rehabilitation of patients with flexor tendon injury. MATERIALS AND METHODS Thirty patients were included and randomly divided between two groups: mirror therapy and conventional treatment. A physical therapy program consisting of whirlpool, ultrasound and transcutaneous electrical nerve stimulation was applied to both groups. In the mirror therapy group, flexor tendon gliding, blocking exercises, joint range of motion and resistance exercises were performed with the healthy hand via a mirror. In the conventional treatment group, the same exercises were performed with the affected hand without mirror. This treatment was continued for 12 sessions over 4 weeks. Joint range of motion, handgrip strength, pain, functionality, dexterity and kinesiophobia were evaluated before and after treatment. RESULTS More improvement was observed in the mirror therapy group in terms of pain on visual analog scale, Patient-Rated Wrist Evaluation, Hand Function Index and Disabilities of the Arm, Shoulder and Hand scores (p = 0.025, p = 0.004, p < 0.001 and p < 0.001, respectively). There was no significant difference between groups for the other parameters (Tampa Kinesiophobia Scale, Purdue Pegboard test, total active range movement, or handgrip strength: p > 0.05). CONCLUSION This study shows that mirror therapy in postoperative rehabilitation of flexor tendon injuries is more effective than conventional in terms of reducing the severity of pain and restoring hand function.
Collapse
Affiliation(s)
- Gözde Yalçın
- Department of Physical Medicine and Rehabilitation, Ankara Research and Training Hospital, Ankara, Turkey.
| | - Cevriye Mülkoğlu
- Department of Physical Medicine and Rehabilitation, Ankara Research and Training Hospital, Ankara, Turkey
| | - Semanur Gülmez
- Department of Physical Medicine and Rehabilitation, Ankara Research and Training Hospital, Ankara, Turkey
| | - Hakan Genç
- Department of Physical Medicine and Rehabilitation, Ankara Research and Training Hospital, Ankara, Turkey
| |
Collapse
|
4
|
Hekim Ö, Çolak TK, Bonab MAR. The effect of mirror therapy in patients with frozen shoulder. Shoulder Elbow 2023; 15:218-227. [PMID: 37035611 PMCID: PMC10078819 DOI: 10.1177/17585732221089181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/10/2021] [Accepted: 02/23/2022] [Indexed: 11/15/2022]
Abstract
Introduction This study was designed to compare mirror therapy and visual feedback with the control group in adhesive capsulitis patients. Methods Thirty-six patients, divided into three groups as mirror therapy, visual feedback and control for 15 sessions of treatment. Evaluations were made before treatment, at 6th and 10th weeks. Bilateral glenohumeral exercise was performed at the end of each session with the affected extremity behind the mirror in the mirror group, with both upper extremities in front of the mirror in the visual feedback group, and without the mirror in the control group. Results There were statistically significant differences between the mirror therapy and visual feedback in terms of pain severity change, and the visual feedback was superior to the change in pain severity compared to the control. Visual feedback showed significant improvement in mean change from baseline to week 10 in shoulder pain and disability index scores compared to control (p = 0.012). There was no significant difference between the groups in terms of modified constant score, proprioception and shoulder range of motion. Conclusion It was determined that the exercises performed by seeing the affected extremity in the mirror were more effective than mirror therapy and control group.
Collapse
Affiliation(s)
- Ömer Hekim
- Physiotherapy and Rehabilitation Department, University of Health Sciences, Hamidiye Institute of Health Sciences, Istanbul, Turkey
| | - Tuğba Kuru Çolak
- Physiotherapy and Rehabilitation Department, Marmara University, Faculty of Health Sciences, Istanbul, Turkey
| | - Masoud Amir Rashedi Bonab
- Physiotherapy and Rehabilitation Department, Marmara University, Faculty of Health Sciences, Istanbul, Turkey
| |
Collapse
|
5
|
ERTÜRK Ç, MUTUŞ R. Activity of Mirror Neurons and Its Effect on Various Diseases. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.1142369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Ayna nöronların nöroanatomik yapılanması ve işlevselliğinin araştırılması son yıllarda oldukça artmıştır. Özellikle nörolojik ve ortopedik hasta gruplarında uygulanan tedavi yaklaşımlarında pasif uygulamalar yerine hastanın katılımının olduğu aktif uygulamalar tercih edilmektedir. Bunun temel sebeplerinden birisi ayna nöronları ve birincil motor korteksi dâhil ederek tedaviyi kalıcı hale getirmeyi amaçlamaktır. Ayna nöronların fonksiyonel ve disfonksiyonel durumlarını ortaya koymak, tedavi seanslarında hastaların semptomlarını anlamada çok büyük katkı sağlamaktadır. Özellikle ayna nöronları aktive ederek planlanan ayna terapisi ile hastalar nöronal bağlantılarını yeniden yapılandırarak nöroplastik aktivite sağlarlar ve böylece iyileşme süreçlerine katkıda bulunmuş olurlar. Literatür taramalarında ayna nöronların aktivasyonlarının yer aldığı hastalıkların yapısal özellikleri birbirinden farklı olsa da ortak özellik olarak ayna nöronların aktive edilerek tedaviye katkı sağladığını söylemek mümkündür. Yapılan tedavi uygulamalarında, ilgili fonksiyonel hareketin hasta tarafından fiziksel olarak yapılmadığı durumlarda dahi bilişsel olarak hareketin yapıldığının imgelenmesi, ayna nöronları aktive ederek hastanın iyilik halini arttırdığı belirlenmiştir.
Collapse
|
6
|
Does mental practice or mirror therapy help prevent functional loss after distal radius fracture? A randomized controlled trial. J Hand Ther 2022; 35:86-96. [PMID: 33308929 DOI: 10.1016/j.jht.2020.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN A randomized, single-blinded controlled trial. INTRODUCTION Therapy results after distal radius fractures (DRF) especially with older patients are often suboptimal. One possible approach for counteracting the problems are motor-cognitive training interventions such as Mental Practice (MP) or Mirror Therapy (MT), which may be applied in early rehabilitation without stressing the injured wrist. PURPOSE OF THE STUDY The aim of the study is to investigate the effects of MP and MT on wrist function after DRF. The pilot study should furthermore provide information about the feasibility of these methods. METHODS Thirty-one women were assigned either to one of the two experimental groups (MP, MT) or to a control group (relaxation intervention). The participants completed a training for six weeks, administered at their homes. Measurements were taken at four times (weeks 0, 3, 6 and 12) to document the progression in subjective function (PRWE, QuickDASH) and objective constraints of the wrist (ROM, grip strength) as well as in health-related quality of life (EQ-5D). RESULTS The results indicated that both experimental groups showed higher improvements across the intervention period compared to the control group; e.g. PRWE: MT 74.0%, MP 66.2%, CG 56.9%. While improvements in grip strength were higher for the MP group, the MT group performed better in all other measures. However, time by group interactions approached significance at best; e.g. ROM: P = .076; ηp2 = .141. CONCLUSION The superiority of MP as well as MT supports the simulation theory. Motor-cognitive intervention programs are feasible and promising therapy supplements, which may be applied in early rehabilitation to counteract the consequences of immobilization without stressing the injured wrist.
Collapse
|
7
|
Tofani M, Santecchia L, Conte A, Berardi A, Galeoto G, Sogos C, Petrarca M, Panuccio F, Castelli E. Effects of Mirror Neurons-Based Rehabilitation Techniques in Hand Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5526. [PMID: 35564920 PMCID: PMC9104298 DOI: 10.3390/ijerph19095526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023]
Abstract
Background: Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduce immobilization time, and various techniques and methods are adopted, depending on the structures involved. Objective: To measure the effects of mirror neurons-based rehabilitation techniques in hand injuries throughout a systematic review and meta-analysis. Methods: The protocol was accepted in PROSPERO database. A literature search was conducted in Cinahl, Scopus, Medline, PEDro, OTseeker. Two authors independently identified eligible studies, based on predefined inclusion criteria, and extracted the data. RCT quality was assessed using the JADAD scale. Results: Seventy-nine suitable studies were screened, and only eleven were included for qualitative synthesis, while four studies were selected for quantitative analysis. Four studies were case reports/series, and seven were RCTs. Nine investigate the effect of Mirror Therapy and two the effect of Motor Imagery. Quantitative analyses revealed Mirror Therapy as effective for hand function recovery (mean difference = −14.80 95% Confidence Interval (CI) = −17.22, −12.38) (p < 0.00001) in the short term, as well as in long follow-up groups (mean difference = −13.11 95% Confidence Interval (CI) = −17.53, −8.69) (p < 0.00001). Clinical, but not statistical, efficacy was found for manual dexterity (p = 0.15), while no benefit was reported for range of motion. Conclusions: Mirror neurons-based rehabilitation techniques, combined with conventional occupational and physical therapy, can be a useful approach in hand trauma. Mirror therapy seems to be effective for hand function recovery, but, for motor imagery and action observation, there is not sufficient evidence to recommend its use. Further research on the efficacy of the mirror neurons-based technique in hand injury is recommended.
Collapse
Affiliation(s)
- Marco Tofani
- Professional Development, Continuous Education and Research Service, Bambino Gesù Children’s Hospital, 00165 Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Luigino Santecchia
- Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, 00100 Rome, Italy;
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
- Neuromed IRCCS, 86077 Pozzili, Italy
| | - Carla Sogos
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.C.); (A.B.); (G.G.); (C.S.)
| | - Maurizio Petrarca
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children’s Hospital, 00100 Rome, Italy; (M.P.); (E.C.)
| | | | - Enrico Castelli
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children’s Hospital, 00100 Rome, Italy; (M.P.); (E.C.)
| |
Collapse
|
8
|
Cuenca-Martínez F, Angulo-Díaz-Parreño S, Feijóo-Rubio X, Fernández-Solís MM, León-Hernández JV, LA Touche R, Suso-Martí L. Motor effects of movement representation techniques and cross-education: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:94-107. [PMID: 34105921 PMCID: PMC9987463 DOI: 10.23736/s1973-9087.21.06893-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The objective was to assess the impact of movement representation techniques (MRT) through motor imagery (MI), action observation (AO) and visual mirror feedback (VMF) and cross-education training (CE) on strength, range of motion (ROM), speed, functional state and balance during experimental immobilization processes in healthy individuals, in patients with injuries that did not require surgery and in those with surgical processes that did or did not require immobilization. EVIDENCE ACQUISITION MEDLINE, EMBASE, CINAHL and Google Scholar were searched. Thirteen meta-analyses were conducted. EVIDENCE SYNTHESIS Regarding the immobilized participants, in the healthy individuals, MI showed significant results regarding maintenance of strength and ROM, with low-quality evidence. Regarding the process with no immobilization, VMF and MI techniques showed significant changes in maintaining ROM in patients with injury without surgery, with very low-quality evidence. Results had shown that MI demonstrated significantly higher maintenance of strength and speed in patients undergoing surgery, with low-quality evidence. No significant results were found in ROM. Low-quality evidence showed better results in AO plus usual care compared with usual treatment in isolation with respect to maintenance of functional state and balance. CE training demonstrated maintenance of strength in patients undergoing surgery, with moderate evidence; however, not in healthy experimentally immobilized individuals. VMF did not show significant results in maintaining ROM after surgery without immobilization, nor did MI in maintaining strength after surgery and immobilization. CONCLUSIONS MRT and CE training have been shown to have a significant impact on the improvement of various motor variables and on physical maintenance in general.
Collapse
Affiliation(s)
- Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain
| | - Santiago Angulo-Díaz-Parreño
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain.,Faculty of Medicine, CEU San Pablo University, Madrid, Spain
| | - Xosé Feijóo-Rubio
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta M Fernández-Solís
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - José V León-Hernández
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain
| | - Roy LA Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain - .,Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain.,Institute of Neurosciences and Craniofacial Pain (INDCRAN), Madrid, Spain
| | - Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), La Salle Higher Center for University Studies, Autonomous University of Madrid, Madrid, Spain.,Department of Physiotherapy, CEU Cardenal Herrera University, CEU Universities, Valencia, Spain
| |
Collapse
|
9
|
Klein I, Kalichman L, Chen N, Susmallian S. A comprehensive approach to risk factors for upper arm morbidities following breast cancer treatment: a prospective study. BMC Cancer 2021; 21:1251. [PMID: 34800988 PMCID: PMC8605604 DOI: 10.1186/s12885-021-08891-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Breast cancer surgery frequently causes deficiencies in shoulder functioning. The study pourpode is to identify risk factors for prolonged pain, reduction in function, and decrease in range of motion (ROM) in BC patients. METHODS A prospective cohort study was designed in a private hospital; between October 2018 and April 2019 with a follow-up of 6 months. Patients following BC surgery, were divided by arm morbidities, and the different risk facrors were evaluated using univariate analysis and logistic regression. RESULTS A total of 157 patients were included in the study. Risk factors for functional disabilities included; pain levels during hospitalization NPRS 1.2 (±0.8) compared to patients with no disabilities 0.5 ± 0.7 (p = .006), the size of tumors more than 1.4 ± 0.8 cm. compared with no morbidities 0.8 ± 0.9 cm. (p = .046), and breast reconstructions (p = .030). Risk factors for prolonged pain includes mastectomy (p = .006), breast reconstruction (p = .011), more than three dissected lymph nodes (p = .002), the presence of preoperative pain (p < .001), in-hospital pain (p < .001), axillary web syndrome (p < .001) and lymphedema (p < .001). Risk factors for decreased ROM were more than three dissected lymph nodes (p = .027), radiation (p = .018), and the size of dissected tissue (p = .035). Postoperative physical therapy appears to reduce the incidence of prolonged pain (p = .013) and regular physical activity may reduce long term functional disabilities (p = .021). CONCLUSIONS Upper arm morbidity following BC treatments affect up to 70% of the patients. Identifying the different risk and beneficial factors may improve awareness among physicians to refer patients to early rehabilitation programs and thus avoid chronic morbidity and improve the course of recovery. TRIAL REGISTRATION The study was registered in Clinical trial with the ID number: NCT03389204 .
Collapse
Affiliation(s)
- Ifat Klein
- Department of Physical Therapy, Assuta Medical Center, Tel Aviv, Israel.,Department of physical therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Leonid Kalichman
- Department of physical therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Noy Chen
- Department of Physical Therapy, Assuta Medical Center, Tel Aviv, Israel
| | - Sergio Susmallian
- Department of Surgery, Assuta Medical Center, 20 Habarzel Street, 69710, Tel Aviv, Israel. .,Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel.
| |
Collapse
|
10
|
Civi Karaaslan T, Berkoz O, Tarakci E. The effect of mirror therapy after carpal tunnel syndrome surgery: A randomised controlled study. HAND SURGERY & REHABILITATION 2020; 39:406-412. [DOI: 10.1016/j.hansur.2020.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
|
11
|
Naughton N, Algar L. Linking commonly used hand therapy outcome measures to individual areas of the International Classification of Functioning: A systematic review. J Hand Ther 2020; 32:243-261. [PMID: 29433763 DOI: 10.1016/j.jht.2017.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 11/25/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Systematic review. INTRODUCTION Identifying outcome measures that correspond to the International Classification of Functioning (ICF) provides insight into selecting appropriate outcome tools in hand therapy practice. PURPOSE OF THE STUDY The objective of this study is to systematically review patient-reported outcome measures commonly used in hand therapy to determine the extent to which the content represents the biopsychosocial view of the ICF. METHODS A comprehensive literature search was conducted. Studies that met inclusion criteria were identified, and outcome measures were extracted. The meaningful concept was determined for each item on the measure and linked to the most specific ICF category. Summary linkage calculations were completed. RESULTS Eleven patient-reported outcomes were identified from 43 included studies. Activity and participation had the highest content coverage followed by body functions. There was linking to personal factors and not defined-disability and mental health. Environmental factors were not represented in any of the included outcome measures. The core set representation of unique codes ranged from 8.55% to 18.80% (mean: 11.97%) for the Comprehensive ICF Core Set for Hand Conditions and from 30.43% to 47.83% (mean: 31.40%) for the Brief ICF Core Set for Hand Conditions. The percent representation of the Comprehensive ICF Core Set for Hand Conditions for unique disability ranged from 21.62% to 43.24% (mean: 20.33%) and from 62.50% to 87.50% (mean: 72.22%) for the Brief ICF Core Set for Hand Conditions. DISCUSSION None of the included measures represent all categories of the ICF Core Sets for Hand Conditions. CONCLUSION Utilizing the most recent refinement rules for the linking process, this study provides comparisons of measures along with clarity of content coverage for the most commonly used tools in the practice of hand therapy.
Collapse
Affiliation(s)
| | - Lori Algar
- Orthopaedic Specialty Group PC, Fairfield, CT, USA
| |
Collapse
|
12
|
Yun DE, Kim MK. Effects of mirror therapy on muscle activity, muscle tone, pain, and function in patients with mutilating injuries: A randomized controlled trial. Medicine (Baltimore) 2019; 98:e15157. [PMID: 31027060 PMCID: PMC6831332 DOI: 10.1097/md.0000000000015157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study assessed the effectiveness of mirror therapy (MT) on muscle elasticity, pain, and function in patients with mutilating injuries. METHODS Thirty patients with impaired function due to mutilating injuries were assigned randomly to experimental or control group. The experimental group (n = 15) received MT (30 minutes a day, 3 days a week for 4 weeks) and conventional physical therapy after each MT session while the control group (n = 15) only received conventional physical therapy. RESULTS There were significant differences in pain and hand function within each group (pre-intervention vs post-intervention) and between groups (experimental vs control) (P < .05). However, there was no significant difference in muscle elasticity between groups (P > .05). CONCLUSION Although MT cannot result in significant changes in muscle elasticity in a clinical setting, it does have positive effects by reducing pain and improving hand function. Thus, MT can be effective for patients with impaired function due to mutilating injuries.
Collapse
Affiliation(s)
- Da-Eun Yun
- Department of Rehabilitation Sciences, Graduate School
| | - Myoung-Kwon Kim
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University, Daegudae-ro, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea
| |
Collapse
|
13
|
Başkaya MÇ, Erçalık C, Karataş Kır Ö, Erçalık T, Tuncer T. The efficacy of mirror therapy in patients with adhesive capsulitis: A randomized, prospective, controlled study. J Back Musculoskelet Rehabil 2019; 31:1177-1182. [PMID: 30056414 DOI: 10.3233/bmr-171050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the effect of mirror therapy (MT) in conjunction with a standard physical therapy program on shoulder range of motion (ROM), pain and quality of life in patients with adhesive capsulitis (AC). METHOD This prospective, randomized, controlled, single blind study included 30 patients with AC who were scheduled to undergo 10 sessions of standard physical therapy. The participants were divided into two identical groups, namely, The MT group and the control group. After each session, the MT group underwent active ROM exercises with the reflective side of the mirror while the control group underwent active ROM exercises with the non-reflective side of the mirror. Pre-treatment and post-treatment shoulder pain (VAS), shoulder function (UCLA shoulder scale) and quality of life (SF-36) were assessed, and active and passive ROM were quantified with a goniometer. RESULTS Both groups revealed a significant reduction of shoulder pain and significant improvement of shoulder function, active and passive ROM, and quality of life after the treatment. Post-treatment measurements showed that the MT group had a significantly lower amount of pain compared to the control group (p= 0.007). The UCLA scores were significantly higher in the MT group (p= 0.003). The MT group had significantly better post-treatment active flexion, active abduction, passive flexion, and passive abduction values (p= 0.001, p= 0.02, p= 0.002, and p= 0.02, respectively). The MT group had significant post-treatment improvement in physical function, physical role limitation and emotional role limitation, and pain parameters including SF-36 (p= 0.003, p= 0.01, p= 0.015, and p= 0.002, respectively). CONCLUSION MT in conjunction with physical therapy appears to be an effective treatment modality that reduces shoulder pain and improves shoulder ROM, shoulder function, and quality of life among patients with AC.
Collapse
Affiliation(s)
- Mehmet Çetin Başkaya
- Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Pain Medicine Clinic, Ankara, Turkey
| | - Cem Erçalık
- Division of Physiotherapy and Rehabilitation, Istanbul Arel University School of Health Sciences, Istanbul, Turkey
| | - Özlem Karataş Kır
- Korkuteli State Hospital, Physical Therapy and Rehabilitation Clinic, Antalya, Turkey
| | - Tülay Erçalık
- Şişli Hamidiye Etfal Training and Research Hospital, Pain Medicine Clinic, Istanbul, Turkey
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| |
Collapse
|
14
|
Abolfazli M, Lajevardi L, Mirzaei L, Abdorazaghi HA, Azad A, Taghizadeh G. The effect of early intervention of mirror visual feedback on pain, disability and motor function following hand reconstructive surgery: a randomized clinical trial. Clin Rehabil 2018; 33:494-503. [PMID: 30458625 DOI: 10.1177/0269215518811907] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE: To determine the effect of mirror visual feedback (MVF) on disability, pain, and motor function on patients who underwent hand reconstructive surgery. DESIGN: Randomized, single-blinded controlled trial. SETTING: Rehabilitation center. SUBJECTS: A total of 40 patients who were randomly assigned into the intervention group ( n = 20) and control group ( n = 20) participated in this study. INTERVENTIONS: The rehabilitation sessions took place twice a week for eight weeks. The control group received traditional rehabilitation for 75 minutes. While the intervention group performed MVF and traditional rehabilitation for 30 and 45 minutes, respectively. MEASURES: Pain and disability of the hand were assessed with McGill pain questionnaire and Disability of Arm, Shoulder, and Hand (DASH) scores. The range of joint motion was evaluated by Goniometer, and the strength of grip and pinch was evaluated by Dynamometer and Pinch gauge and dexterity evaluated by Minnesota Manual Muscle test. RESULTS: The results indicated that both traditional and MVF methods induced significant decreasing pain (Pain Rate Index: F = 68.48, P = 0.000; Number of Word Count: F = 70.96, P = 0.000), disability ( F = 50.08, P = 0.000) and increasing dexterity (placing test: F = 28.73, P = 0.000), and range of motion ( F = 33.16, P = 0.000). The results also showed that the positive effect of MVF on pain, disability, dexterity, and range of motion was significantly greater than that of controls ( P < 0.05), but there was no significant result in grip and lateral pinch strength between the intervention and control group ( P > 0.05). CONCLUSION: MVF, in conjunction with traditional rehabilitation programs, may lead to greater improvements in pain, disability, placing dexterity, and range of motion. But it seems not to be effective on pinch and grip power and turning dexterity.
Collapse
Affiliation(s)
- Mahsa Abolfazli
- 1 School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Laleh Lajevardi
- 2 Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Leila Mirzaei
- 3 Department of Hand and Upper Extremity Therapy, Hazrat Fatemeh Educational and Medical Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hosein Ali Abdorazaghi
- 4 Sina Hospital, Faculty Member of Medical Department, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Akram Azad
- 2 Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ghorban Taghizadeh
- 2 Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| |
Collapse
|
15
|
Saberi F, Lajevardi L, Azad A, Mirzaie L, Taghizadeh G, Abdolrazaghi HA. Can mirror visual feedback improve sensory relearning outcomes following median/ulnar nerve repair? INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.10.552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Farzaneh Saberi
- MSc student of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Laleh Lajevardi
- Assistant professor, Department of Occupational Therapy School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Assistant Professor, Department of Occupational Therapy School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Mirzaie
- Lecturer, Department of Hand and Upper Extremity Hazrate Fateme Educational and Medical Hospital, Tehran, Iran
| | - Ghorban Taghizadeh
- Assistant Professor, Department of Occupational Therapy School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ali Abdolrazaghi
- Assistant Professor, Fellowship of Hand Surgery, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Suzuki Y, Mikawa T, Ikuta M. Effects of mirror therapy on the reacquisition of motor imagery in patients with a hand orthopaedic injury. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1520469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Yusuke Suzuki
- Faculty of Health & Medicalcare, Shonan University of Medical Sciences 16-48, Kamisinano, Yokohama City, Kanagawa 244-0806, Japan
| | - Toshimasa Mikawa
- Faculty of Health & Medicalcare, Shonan University of Medical Sciences 16-48, Kamisinano, Yokohama City, Kanagawa 244-0806, Japan
| | - Munehiro Ikuta
- Faculty of Health & Medicalcare, Shonan University of Medical Sciences 16-48, Kamisinano, Yokohama City, Kanagawa 244-0806, Japan
| |
Collapse
|
17
|
Resnik L, Borgia M, Silver B, Cancio J. Systematic Review of Measures of Impairment and Activity Limitation for Persons With Upper Limb Trauma and Amputation. Arch Phys Med Rehabil 2017; 98:1863-1892.e14. [DOI: 10.1016/j.apmr.2017.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/05/2017] [Accepted: 01/11/2017] [Indexed: 01/04/2023]
|
18
|
Roll SC, Hardison ME. Effectiveness of Occupational Therapy Interventions for Adults With Musculoskeletal Conditions of the Forearm, Wrist, and Hand: A Systematic Review. Am J Occup Ther 2017; 71:7101180010p1-7101180010p12. [PMID: 28027038 PMCID: PMC5182014 DOI: 10.5014/ajot.2017.023234] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity. It is imperative that practitioners understand the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purposeful occupations. This systematic review provides an update to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question, What is the evidence for the effect of occupational therapy interventions on functional outcomes for adults with musculoskeletal disorders of the forearm, wrist, and hand? A total of 59 articles were reviewed. Evidence for interventions was synthesized by condition within bone, joint, and general hand disorders; peripheral nerve disorders; and tendon disorders. The strongest evidence supports postsurgical early active motion protocols and splinting for various conditions. Very few studies have examined occupation-based interventions. Implications for occupational therapy practice and research are provided.
Collapse
Affiliation(s)
- Shawn C Roll
- Shawn C. Roll, PhD, OTR/L, RMSKS, FAOTA, is Assistant Professor, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Mark E Hardison
- Mark E. Hardison, MS, OTR/L, is PhD Student, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| |
Collapse
|
19
|
Mirror therapy for rehabilitation following Achilles tendon rupture. Med Hypotheses 2016; 96:34. [PMID: 27959271 DOI: 10.1016/j.mehy.2016.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/23/2016] [Indexed: 11/22/2022]
|
20
|
Hartman K, Altschuler EL. Mirror Therapy for Hemiparesis Following Stroke: A Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016. [DOI: 10.1007/s40141-016-0131-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
21
|
Dacombe PJ, Amirfeyz R, Davis T. Patient-Reported Outcome Measures for Hand and Wrist Trauma: Is There Sufficient Evidence of Reliability, Validity, and Responsiveness? Hand (N Y) 2016; 11:11-21. [PMID: 27418884 PMCID: PMC4920509 DOI: 10.1177/1558944715614855] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are important tools for assessing outcomes following injuries to the hand and wrist. Many commonly used PROMs have no evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. This systematic review examines the PROMs used in the assessment of hand and wrist trauma patients, and the evidence for reliability, validity, and responsiveness of each measure in this population. METHODS A systematic review of Pubmed, Medline, and CINAHL searching for randomized controlled trials of patients with traumatic injuries to the hand and wrist was carried out to identify the PROMs. For each identified PROM, evidence of reliability, validity, and responsiveness was identified using a further systematic review of the Pubmed, Medline, CINAHL, and reverse citation trail audit procedure. RESULTS The PROM used most often was the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; the Patient-Rated Wrist Evaluation (PRWE), Gartland and Werley score, Michigan Hand Outcomes score, Mayo Wrist Score, and Short Form 36 were also commonly used. Only the DASH and PRWE have evidence of reliability, validity, and responsiveness in patients with traumatic injuries to the hand and wrist; other measures either have incomplete evidence or evidence gathered in a nontraumatic population. CONCLUSIONS The DASH and PRWE both have evidence of reliability, validity, and responsiveness in a hand and wrist trauma population. Other PROMs used to assess hand and wrist trauma patients do not. This should be considered when selecting a PROM for patients with traumatic hand and wrist pathology.
Collapse
Affiliation(s)
- Peter Jonathan Dacombe
- University Hospitals Bristol, Bristol Royal Infirmary, Bristol, England,Peter Jonathan Dacombe, University Hospitals Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, England.
| | - Rouin Amirfeyz
- University Hospitals Bristol, Bristol Royal Infirmary, Bristol, England
| | - Tim Davis
- Queen’s Medical Centre, Nottingham, England
| |
Collapse
|
22
|
Kim K, Lee S, Kim D, Lee K, Kim Y. Effects of mirror therapy combined with motor tasks on upper extremity function and activities daily living of stroke patients. J Phys Ther Sci 2016; 28:483-7. [PMID: 27065534 PMCID: PMC4792995 DOI: 10.1589/jpts.28.483] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 10/31/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The objective of this study was to investigate the effects of mirror therapy
combined with exercise tasks on the function of the upper limbs and activities of daily
living. [Subjects and Methods] Twenty-five stroke patients who were receiving physical
therapy at K Hospital in Gyeonggi-do, South Korea, were classified into a mirror therapy
group (n=12) and a conventional therapy group (n=13). The therapies were applied for 30
minutes per day, five times per week, for a total of four weeks. Upper limb function was
measured with the Action Research Arm test, the Fugl-Meyer Assessment, and the Box and
Block test, and activities of daily living were measured with the Functional Independence
Measure. A paired test was performed to compare the intragroup differences between before
training and after four weeks of therapy, and an independent t-test was performed to
compare the differences between the two groups before and after four weeks of therapy.
[Results] In the intragroup comparison, both groups showed significant differences between
measurements taken before and after four weeks of therapy. In the intergroup comparison,
the mirror therapy group showed significant improvements compared with the conventional
therapy group, both in upper limb function and activities of daily living. [Conclusion]
The findings of this study demonstrated that mirror therapy is more effective than
conventional therapy for the training of stroke patients to improve their upper limb
function and activities of daily living.
Collapse
Affiliation(s)
- Kyunghoon Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Sukmin Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | | | | | - Youlim Kim
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| |
Collapse
|
23
|
Paula MH, Barbosa RI, Marcolino AM, Elui VMC, Rosén B, Fonseca MCR. Early sensory re-education of the hand after peripheral nerve repair based on mirror therapy: a randomized controlled trial. Braz J Phys Ther 2016; 20:58-65. [PMID: 26786080 PMCID: PMC4835165 DOI: 10.1590/bjpt-rbf.2014.0130] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 07/22/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND: Mirror therapy has been used as an alternative stimulus to feed the somatosensory
cortex in an attempt to preserve hand cortical representation with better
functional results. OBJECTIVE: To analyze the short-term functional outcome of an early re-education program
using mirror therapy compared to a late classic sensory program for hand nerve
repair. METHOD: This is a randomized controlled trial. We assessed 20 patients with median and
ulnar nerve and flexor tendon repair using the Rosen Score combined with the DASH
questionnaire. The early phase group using mirror therapy began on the first
postoperative week and lasted 5 months. The control group received classic sensory
re-education when the protective sensation threshold was restored. All
participants received a patient education booklet and were submitted to the
modified Duran protocol for flexor tendon repair. The assessments were performed
by the same investigator blinded to the allocated treatment. Mann-Whitney Test and
Effect Size using Cohen's d score were used for inter-group comparisons at 3 and 6
months after intervention. RESULTS: The primary outcome (Rosen score) values for the Mirror Therapy group and classic
therapy control group after 3 and 6 months were 1.68 (SD=0.5); 1.96 (SD=0.56) and
1.65 (SD=0.52); 1.51 (SD=0.62), respectively. No between-group differences were
observed. CONCLUSION: Although some clinical improvement was observed, mirror therapy was not shown to
be more effective than late sensory re-education in an intermediate phase of nerve
repair in the hand. Replication is needed to confirm these findings.
Collapse
Affiliation(s)
- Mayara H Paula
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Valéria M C Elui
- Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | | | - Marisa C R Fonseca
- Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| |
Collapse
|
24
|
Christoff M. The impact of a hand therapy screening on patients referred for surgical opinion. J Hand Ther 2014; 27:70-1. [PMID: 24439460 DOI: 10.1016/j.jht.2013.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 12/07/2013] [Indexed: 02/03/2023]
|
25
|
Schott N, Korbus H. Preventing functional loss during immobilization after osteoporotic wrist fractures in elderly patients: a randomized clinical trial. BMC Musculoskelet Disord 2014; 15:287. [PMID: 25175985 PMCID: PMC4158045 DOI: 10.1186/1471-2474-15-287] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/26/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Distal radius fractures are among the most common fractures and account for approximately one-sixth of all fractures diagnosed. Therapy results after distal radius fracture, especially of elderly patients, are often suboptimal. The inevitable immobilization for several weeks leads to reduction in range of motion, deterioration of muscle strength, malfunction of fine motor skills as well as changes of motor and sensory representations in the brain. Currently, there are no strategies to counteract these immobilization problems. The overall aim of the study is to investigate the therapeutic potential of motor-cognitive approaches (mental practice or mirror therapy) on hand function after wrist fracture. METHODS/DESIGN This study is a controlled, randomized, longitudinal intervention study with three intervention groups. One experimental group imagines movements of the fractured upper extremity without executing them (mental practice). The second experimental group receives a mirror therapy program consisting of the performance of functional movement synergies using the unaffected forearm, wrist, and hand. The control group completes a relaxation training regime. Additionally, all patients receive usual care by the general practitioner. We include women aged 60 years and older having a distal radius fracture and sufficient cognitive function. All groups are visited at home for therapy sessions 5 times per week for the first 3 weeks and 3 times per week for weeks 4 to 6. Measurements are taken at therapy onset, and after 3, 6 and 12 weeks. The primary outcome measure will assess upper extremity functioning (Patient-Rated Wrist Evaluation [PRWE]), while secondary outcome measures cover subjective wrist function (Disabilities of the Arm and Shoulder; [DASH], objective impairment (range of motion, grip force) and quality of life (EuroQol-5D, [EQ5D]). DISCUSSION Results from this trial will contribute to the evidence on motor-cognitive approaches in the early therapy of distal radius fractures. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov with registration number NCT01394809 and was granted permission by the Medical Ethical Review Committee of the University of Tübingen in June 2011.
Collapse
Affiliation(s)
- Nadja Schott
- Department of Sports and Exercise Science, University of Stuttgart, Allmandring 28, 70569 Stuttgart, Germany
| | - Heide Korbus
- Department of Sports and Exercise Science, University of Stuttgart, Allmandring 28, 70569 Stuttgart, Germany
| |
Collapse
|