Investigations of the effects of mirror therapy in children with unilateral cerebral palsy

Abstract

Cerebral palsy (CP) is the first cause of children motor disability. In unilateral CP, upper limb dysfunctions are the main cause of dependence and participation restriction. Effects of mirror therapy are well known in others disorders, especially in adult population but its benefit is not yet determined in children with cerebral palsy. The aim of this study is to determine the efficacy of mirror therapy in children with unilateral cerebral palsy on bimanual activity. This study was a prospective, randomized, single-center, controlled, single-blind study. The primary efficacy variable was the Assisting Hand Assessment (AHA). Thirty-two hemiparesis (17 in mirror therapy group and 15 in control group) children aged over 7 were evaluated using the AHA to score functional activity performance. The mirror therapy group used a mirror, the comparison group used an opaque partition between their arms. Each participant had 5 rehabilitation sessions for 5 weeks. Each child was evaluated initially (S0), at 5 weeks (S5) and 10 (S10) weeks. AHA score at 5 weeks were 61.44 ± 11.99 for the 32 patients, 61.60 ± 11.72 in control group, 61.29 ± 12.58 in mirror therapy group ( P = 0.9440). At 10 weeks, scores were 61.9 ± 11.4 for the entire population, 61.4 ± 11.8 in control group and 62.4 ± 11.4 in mirror therapy group ( P = 0.8178). There were no significant differences in outcomes and their progression S5 and S10 between the mirror therapy group and control group. Neither primary nor secondary efficacy variables have shown significant differences. Even though our study did not show improvement in AHA score after 5 weeks of mirror therapy, we can observe an improvement tendency that could be statically significative with a larger population.