Abstract
Mirror therapy (MT) facilitates motor learning and induces cortical reorganization and motor recovery from stroke. We applied the new digital mirror therapy (DMT) system to compare the cortical activation under the three visual feedback conditions: (1) no mirror visual feedback (NoMVF), (2) bilateral synchronized task-based mirror visual feedback training (BMVF), and (3) reciprocal task-based mirror visual feedback training (RMVF). During DMT, EEG recordings, including time-dependent event-related desynchronization (ERD) signal amplitude in both mu and beta bands, were obtained from the standard C3 (ispilesional hemisphere, IH), C4 (contralesional hemisphere, CH), and Cz scalp sites (supplementary motor area, SMA). The entire ERD curve was separated into three time-phases: P0 (−2 to 0 s), P1 (0 to 2 s), and P2 (2 to 4 s). Four-way and subsequent repeated-measures analyses of variance were used to examine the effects of group (stroke vs. control group), test condition (NoMVF, BMVF, and RMVF), time-phase (P0, P1, and P2), and brain area (IH, CH, SMA) on the ERD areas (%) in mu and beta bands. For the mu band, generally, ERD areas (%) were larger in the control than in the stroke group. The ERD areas (%) were largest under the RMVF condition, followed by BMVF and NoMVF conditions. Similar results were found in the beta bands. The main effects of group, time-phase, and test condition on the ERD areas (%) were significant for the three brain areas, except the main effect of group in the SMA (Cz) and CH (C4) brain area. The ERD areas (%) were larger in the control than in the stroke group. The ERD area (%) was significantly larger during P1 than during P0 and P2 (ps < 0.02), and during P2 than during P0 (ps < 0.01). The ERD area (%) under the RMVF condition was significantly larger than that under the BMVF condition and NoMVF condition (ps < 0.05). The present study suggests that cortical activation particularly in the SMA (Cz) of the brain increases in the RMVF condition in both healthy subjects and stroke patients. This result supports the hypothesis that stroke patients may benefit from RMVF training.
Highlights
The number of stroke patients living with motor impairments is a significant public health concern
The results of the four-way repeat-measures analyses of variance (ANOVA) showed that the group, the test condition, and the time phase were significant factors on the event-related desynchronization (ERD) areas (%) (p < 0.001)
For the IH brain area (C3), the ERD areas (%) of the stroke group were smaller than the control group during the three-time phases (Figure 3A)
Summary
The number of stroke patients living with motor impairments is a significant public health concern. Upper extremity complications are common following stroke and may be seriously debilitating, causing the stroke patient to experience difficulties with activities of daily living [1, 2]. Various treatment methods for upper extremity rehabilitation have emerged; these include virtual reality, robot-arm training, mental practice, and mirror therapy (MT) [6,7,8,9,10,11]. MT is a costeffective and simple alternative method for stroke rehabilitation It involves creation of a reflective illusion of the affected limb with an action-observation technique. MT provides visual feedback impressions created by observing the image of the less-affected upper extremity projected over the affected limb. Mirror visual feedback is thought to restore cortical reorganization, and thereby to improve motor recovery in weak or paralyzed limbs
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
