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
|
Adamo P, Longhi G, Temporiti F, Marino G, Scalona E, Fabbri-Destro M, Avanzini P, Gatti R. Effects of Action Observation Plus Motor Imagery Administered by Immersive Virtual Reality on Hand Dexterity in Healthy Subjects. Bioengineering (Basel) 2024; 11:398. [PMID: 38671819 PMCID: PMC11048356 DOI: 10.3390/bioengineering11040398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Action observation and motor imagery (AOMI) are commonly delivered through a laptop screen. Immersive virtual reality (VR) may enhance the observer's embodiment, a factor that may boost AOMI effects. The study aimed to investigate the effects on manual dexterity of AOMI delivered through immersive VR compared to AOMI administered through a laptop. To evaluate whether VR can enhance the effects of AOMI, forty-five young volunteers were enrolled and randomly assigned to the VR-AOMI group, who underwent AOMI through immersive VR, the AOMI group, who underwent AOMI through a laptop screen, or the control group, who observed landscape video clips. All participants underwent a 5-day treatment, consisting of 12 min per day. We investigated between and within-group differences after treatments relative to functional manual dexterity tasks using the Purdue Pegboard Test (PPT). This test included right hand (R), left hand (L), both hands (B), R + L + B, and assembly tasks. Additionally, we analyzed kinematics parameters including total and sub-phase duration, peak and mean velocity, and normalized jerk, during the Nine-Hole Peg Test to examine whether changes in functional scores may also occur through specific kinematic patterns. Participants were assessed at baseline (T0), after the first training session (T1), and at the end of training (T2). A significant time by group interaction and time effects were found for PPT, where both VR-AOMI and AOMI groups improved at the end of training. Larger PPT-L task improvements were found in the VR-AOMI group (d: 0.84, CI95: 0.09-1.58) compared to the AOMI group from T0 to T1. Immersive VR used for the delivery of AOMI speeded up hand dexterity improvements.
Collapse
Affiliation(s)
- Paola Adamo
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Gianluca Longhi
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Federico Temporiti
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Giorgia Marino
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Emilia Scalona
- Dipartimento di Scienze Medico Chirurgiche, Scienze Radiologiche e Sanità Pubblica (DSMC), Università Degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Brescia, Italy
| | - Maddalena Fabbri-Destro
- Consiglio Nazionale Delle Ricerche, Istituto di Neuroscienze, Via Volturno, 39-E, 43125 Parma, Parma, Italy
| | - Pietro Avanzini
- Consiglio Nazionale Delle Ricerche, Istituto di Neuroscienze, Via Volturno, 39-E, 43125 Parma, Parma, Italy
| | - Roberto Gatti
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| |
Collapse
|
3
|
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
|
4
|
Mollà-Casanova S, Page Á, López-Pascual J, Inglés M, Sempere-Rubio N, Aguilar-Rodríguez M, Muñoz-Gómez E, Serra-Añó P. Effects of mirror neuron activation therapies on functionality in older adults: Systematic review and meta-analysis. Geriatr Nurs 2024; 56:115-123. [PMID: 38346365 DOI: 10.1016/j.gerinurse.2024.02.006] [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: 12/13/2023] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE To identify the effects of mirror neuron activation (MNAT) combined or not with physical exercise (PE) in healthy older adults, on functionality, balance, gait velocity and risk of falls. METHODS A systematic electronic search was performed in PubMed/MEDLINE, Cochrane, and Embase databases. RESULTS Thirteen randomized controlled trials were included in the qualitative analysis, and eleven in the quantitative analysis. All studies showed fair to high quality and the most frequent high-risk bias was "Blinding of participants and personnel". Compared to the control condition, higher improvement was shown in older people who received MNAT, on functionality (1.57 [0.57, 2.62], balance (1.95 [1.32, 2.572]), and gait velocity (1.20 [0.30, 2.11]). Compared to PE, MNAT combined with PE does not improve functionality. More studies are needed to assess MNAT effectiveness in the rest of the outcomes. CONCLUSIONS Neuron system activation through MNAT improves relevant abilities in older adults, with better results when including functional activities. However, the beneficial effects on these variables of adding MNAT to a PE program are controversial.
Collapse
Affiliation(s)
- Sara Mollà-Casanova
- UBIC research group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Álvaro Page
- Instituto Universitario de Ingeniería Mecánica y Biomecánica, Universitat Politècnica de València, Camino de Vera s/n E46022, Valencia, Spain
| | - Juan López-Pascual
- Instituto de Biomecánica de Valencia, Universitat Politècnica de València, Camino de Vera s/n E46022, Valencia, Spain
| | - Marta Inglés
- UBIC research group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Núria Sempere-Rubio
- UBIC research group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- UBIC research group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Elena Muñoz-Gómez
- UBIC research group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Pilar Serra-Añó
- UBIC research group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| |
Collapse
|
5
|
Świta M, Szymonek P, Talarek K, Tomczyk-Warunek A, Turżańska K, Posturzyńska A, Winiarska-Mieczan A. Complex Regional Pain Syndrome after Distal Radius Fracture-Case Report and Mini Literature Review. J Clin Med 2024; 13:1122. [PMID: 38398434 PMCID: PMC10889771 DOI: 10.3390/jcm13041122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/27/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
This study explores the impact of the complex regional pain syndrome (CRPS) on the lives and mobility of patients, with a particular focus on its emergence as a late complication of distal radius fractures (DRFs), a common occurrence, especially among an aging population. The absence of a standardized treatment for the CRPS and the challenge of predicting its occurrence make it a complex medical issue. This research aims to shed light on the effects of treating the CRPS through a case study involving a 75-year-old woman with untreated osteoporosis who experienced a Colles fracture after a fall. The initial management involved repositioning and stabilizing the fractured forearm with a plaster cast, followed by an operation using percutaneous pinning via a Kirschner wire. Subsequently, the patient developed CRPS symptoms and was admitted to the rehabilitation department three months post-fracture. The affected forearm exhibited swelling, warmth, pain, and severely limited range of motion. Treatment involved a combination of medications, physiotherapy, and kinesiotherapy. Significantly, the patient experienced notable improvement following these interventions. This study underscores the absence of a definitive standard for CRPS treatment but suggests that proper rehabilitation and pharmaceutical interventions can contribute positively to patient outcomes. The case further highlights the potential association between DRF and CRPS development, emphasizing the need for continued research in this field.
Collapse
Affiliation(s)
- Michał Świta
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (M.Ś.); (P.S.); (K.T.); (A.P.)
| | - Paweł Szymonek
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (M.Ś.); (P.S.); (K.T.); (A.P.)
| | - Konrad Talarek
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (M.Ś.); (P.S.); (K.T.); (A.P.)
| | - Agnieszka Tomczyk-Warunek
- Laboratory of Locomotor Systems Research, Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
| | - Karolina Turżańska
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (M.Ś.); (P.S.); (K.T.); (A.P.)
| | - Agnieszka Posturzyńska
- Department of Rehabilitation and Orthopedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (M.Ś.); (P.S.); (K.T.); (A.P.)
| | - Anna Winiarska-Mieczan
- Department of Bromatology and Nutrition Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Akademicka St. 13, 20-950 Lublin, Poland;
| |
Collapse
|
6
|
Eren T, Kuru CA, Harput G, Leblebicioglu G. Case-based report of graded motor imagery experience in traumatic brachial plexus injury: The art of moving without moving. J Hand Ther 2024; 37:161-169. [PMID: 37586989 DOI: 10.1016/j.jht.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND We reported a 24-year-old woman who sustained multiple upper limb injuries after a traffic accident in March 2017. She sustained a C7-T1 brachial plexus injury and radial nerve injury on the left side diagnosed in November 2017. The patient underwent radial nerve reconstruction. The patient began her comprehensive therapy program in January 2018. PURPOSE To describe the use of graded motor imagery (GMI) and outcomes after traumatic brachial plexus palsy. We presented changes in electromyographic (EMG) activity of target muscles during task execution and functional status following 10-session GMI therapy. STUDY DESIGN Case report. METHODS The program included 4 sessions of motor imagery and 6 sessions of a combination of motor imagery and mirror therapy. RESULTS The patient successfully participated in the program with reported improvements in EMG activity, functional status, emotional well-being, and body awareness. CONCLUSIONS GMI therapy appears to have peripheral motor effects, including altered surface EMG activity and contributes to a favorable outcome in the functional level of the affected arm. An improved emotional state and awareness of the affected hand could have a positive effect on function. Future long-term randomized controlled trials are needed to investigate the cumulative peripheral effects of treatment of graded motor imagery and the effects of variables mediating its effects on functional performance in patients with nerve injury.
Collapse
Affiliation(s)
- Tuba Eren
- Beykent University, Faculty of Health Sciences, Istanbul, Turkey
| | - Cigdem Ayhan Kuru
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Gulcan Harput
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | | |
Collapse
|
7
|
Agnelli M, Libeccio B, Frisoni MC, Bolzoni F, Temporiti F, Gatti R. Action observation plus motor imagery and somatosensory discrimination training are effective non-motor approaches to improve manual dexterity. J Hand Ther 2024; 37:94-100. [PMID: 37580196 DOI: 10.1016/j.jht.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 03/22/2023] [Accepted: 05/01/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Action observation plus motor imagery (AOMI) and somatosensory discrimination training (SSDT) represent sensory input-based approaches to train the motor system without necessarily asking subjects to perform active movements. PURPOSE To investigate AOMI and SSDT effects compared to no intervention on manual dexterity in healthy subjects. STUDY DESIGN Randomized controlled study. METHODS Sixty healthy right-handed participants were randomized into AOMI, SSDT or Control (CTRL) groups. AOMI observed video-clips including right-hand dexterity tasks and concurrently performed motor imagery, SSDT performed surfaces recognition and 2-point distance discrimination tasks with the right hand, whereas CTRL underwent no intervention. A blinded physiotherapist assessed participants for manual dexterity using the Purdue Pegboard Test (Right hand-R, Left hand-L, Both hands-B, R+L+B and assembly tasks) at baseline (T0) and training end (T1). A mixed-design Analysis of Variance with Time as within-subject factor and Group as between-subject factor was used to investigate between-group differences over time. RESULTS A Time by Group interaction and Time effect were found for R task, which increased from T0 to T1 in all groups with very large effect sizes for SSDT (d = 1.8, CI95 2.4-1.0, P < .001) and AOMI (d = 1.7, CI95 2.5-1.0, P < .001) and medium effect size for CTRL (d = 0.6, CI95 1.2-0.2, P < .001). Between-group post-hoc comparison for deltas (T1-T0) showed large effect size (d = 1.0, CI95 1.6-0.3, P = .003) in favor of SSDT and medium effect size (d = 0.7, CI95 1.4-0.1, P = .026) in favor of AOMI compared to CTRL. Time effects were found for L, B, R + L + B and assembly tasks (P < .001). CONCLUSIONS AOMI and SSDT induced greater manual dexterity improvements than no intervention. These findings supported the role of visual and somatosensory stimuli in building a motor plan and enhancing the accuracy of hand movements. These non-motor approaches may enhance motor performance in job or hobbies requiring marked manual dexterity.
Collapse
Affiliation(s)
- Miriana Agnelli
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Benedetta Libeccio
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Maria Chiara Frisoni
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
| | - Francesco Bolzoni
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Federico Temporiti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Roberto Gatti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| |
Collapse
|
8
|
Muñoz-Gómez E, Aguilar-Rodríguez M, Inglés M, Mollà-Casanova S, Sempere-Rubio N, Serra-Añó P. Effects of mirror therapy on pain, sensitivity and functionality in patients with unilateral carpal tunnel syndrome. Randomised control trial. Disabil Rehabil 2023:1-9. [PMID: 37947269 DOI: 10.1080/09638288.2023.2280705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE To investigate the effects of mirror therapy (MT) and therapeutic exercise (TE) with the unaffected hand, on pain, sensitivity and functionality in individuals with unilateral carpal tunnel syndrome (CTS). MATERIAL AND METHODS A randomized controlled trial was carried out. Thirty-nine adults with unilateral CTS were included and randomly allocated to a six-week training programme based on MT (n = 20) or TE (n = 19). Visual Analogue Scale, Semmes-Weinstein monofilament test, Two-point discrimination (2PD), Disabilities of the Arm, Shoulder and Hand (DASH) and Boston Carpal Tunnel Questionnaire (BCTQ) were assessed before (T0) and after the intervention (T1), and at one-month follow-up (T2). RESULTS At T1, MT and TE showed significant improvements in pain (p = 0.001 and p = 0.03, respectively), however, only MT maintained the achieved effects at T2 (p = 0.01). In addition, 2PD significantly improved in MT in the first (p = 0.04) and fourth fingers (p = 0.02) at T1. The DASH score decreased at T1 in MT (p < 0.001) and TE (p = 0.01). Additionally, the BCTQ score improved in MT (p < 0.001), and TE (p < 0.001) at T1. The effects were maintained at T2 for DASH and BCTQ scores. CONCLUSIONS Training of the unaffected hand resulted in a significant improvement of the affected hand in both groups; nevertheless, MT achieved a longer duration of the effects.
Collapse
Affiliation(s)
- Elena Muñoz-Gómez
- UBIC Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- UBIC Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Inglés
- UBIC Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Sara Mollà-Casanova
- UBIC Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Núria Sempere-Rubio
- UBIC Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pilar Serra-Añó
- UBIC Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| |
Collapse
|
9
|
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
|