Mirror Therapy Group Research Articles

Functional outcome of mirror therapy versus task oriented training on hand function in children with unilateral cerebral palsy

Background. Unilateral cerebral palsy (UCP) is a kind of spastic cerebral palsy which is characterized by atypical posture of upper limb, poor eye-hand coordination, and reduced hand skills. These symptoms can restrict a child’s ability to engage in life activities. Purpose. To compare the effectiveness of mirror therapy as well as task-oriented training on hand functions improvement among UCP children. Methods. Sixty children suffering from UCP were randomly allocated into three equal groups. A schemed physical therapy protocol was utilized to the control, mirror therapy (MT), and task-oriented training (TOT) groups. The protocols of mirror therapy and task-oriented training were administered to MT and TOT groups respectively. Assessments of upper extremity skills, hand dexterity, wrist extension range of motion, along with overall grip strength were conducted at baseline and after intervention using the Quality of Upper Extremity Skills Test (QUEST), Box and Block Test (BBT), universal goniometer, as well as pneumatic squeeze handheld dynamometer respectively. Throughout a total of twelve consecutive weeks, the intervention session was held three days a week. Results. The change amount in all measured hand outcomes were significantly improved following the intervention in all three groups, with the TOT group showing a larger significant effect. Conclusion. Task-oriented training had superior impact than mirror therapy in enhancing hand functions among children having UCP.

Effect of Constraint-Induced Movement Therapy and Mirror Therapy on The Patients with Subacute Stroke in Bangladesh

Background: Subacute stroke is a health-related problem that spans a period from two days to two weeks. A marked disability results from stroke causes remarkable burden on family and society. Objective: To find out the effectiveness of constraint-induced movement therapy (CIMT) and combined mirror therapy on patients with subacute stroke. Comparison of effectiveness in between combined therapy and CIMT. Materials and Methods: Eighteen patients with subacute stroke were enrolled and randomly divided into three groups: CIMT combined with mirror therapy group, CIMT only group, and control group. Two weeks of CIMT for 6 hours a day with or without mirror therapy for 30 minutes a day were performed under supervision. All groups received conventional occupational therapy for 40 minutes a day for the same period. The CIMT-only group and control group also received additional self-exercise to substitute for mirror therapy. Results: We performed the Fugl-Meyer assessment, which was 32.67±21.70 pre-treatment and 37.00±21.06 post-treatment with a p-value of 0.011, MRC muscle grading pre-treatment 3.01±2.78 and 3.21±1.35 post-treatment with a p-value of 0.107, and Modified Barthel Index pre-treatment 29.56±27.43 and 28.33±26.71 post-treatment with a p-value of 0.104. After two weeks of treatment, we had found that CIMT along with mirror therapy, had more impact on subacute stroke patients. Conclusion: Disability limitation following stroke should focused more. Among various treatment facilities CIMT shown promising result along with exercise and mirror therapy. Care-giver’s education, tele-rehabilitation facility, supervision of exercise will reduce hazard of attending hospital in small interval. Early initiation of rehabilitation program yield better results. KYAMC Journal Volume: 15, No: 01, April 2024: 33-39.

Effects of mirror therapy in post-traumatic complex regional pain syndrome type-1: a randomized controlled study.

To investigate the effects of mirror therapy applied in addition to routine rehabilitation on clinical outcomes in post-traumatic complex regional pain syndrome type 1. Single-blind randomized controlled trial. Patients with trauma-induced complex regional pain syndrome type 1 of the hand receiving outpatient rehabilitation. Patients were randomized into mirror therapy and control groups. All patients received routine physical therapy and rehabilitation for 20 sessions (5 sessions/week, for 4 weeks). The mirror group received additional mirror therapy at each session. The primary outcome was pain intensity by numeric rating scale. Secondary outcomes were grip/pinch strength, hand/wrist circumference, dexterity, hand activities, and health-related quality of life. All assessments were performed before and immediately after the treatment, and 4 weeks later at follow-up. Forty patients were enrolled, 20 in each group. Both groups revealed statistically significant improvements from therapy regarding pain, grip/pinch strength, wrist circumference, dexterity, and hand activities (p < 0.05). When groups were compared regarding the improvements in assessment parameters, no statistically significant difference was found between the 2 groups in any of the outcomes (p > 0.05). Mirror therapy applied in addition to routine therapy in post-traumatic complex regional pain syndrome type 1 did not provide extra benefit to the improvement of pain, function, and other clinical outcomes.

The Effects of mirror therapy in postural and kinesthetic rehabilitation on stance phase of gait in subacute stroke

Background: This study explored the effectiveness of mirror therapy in improving postural and kinesthetic rehabilitation during the stance phase of gait in subacute stroke patients. Given the crucial role of balance and functional recovery in enhancing mobility and overall quality of life in stroke survivors, the primary focus was on these aspects. Objective: The primary objective was to evaluate the impacts of mirror therapy on postural and kinesthetic rehabilitation during the stance phase of gait in subacute stroke patients. Methods: A randomized controlled trial was conducted over nine months in Rahim Yar Khan, involving both private and government hospitals. Sixty-four participants were randomly assigned to two groups: the Conventional+KTR group and the Mirror Therapy group, with 32 participants in each. Inclusion criteria required participants to have a single episode of hemiplegic subacute stroke diagnosed by a neurologist, inclusion of both ischemic and hemorrhagic stroke, and sufficient cognitive ability to follow instructions as indicated by a Mini-Mental State Examination (MMSE) score of 24 or higher. Mild spasticity in all joints of the affected limb was defined by a Modified Ashworth Scale score of less than 3. The intervention for the experimental group involved mirror therapy conducted four days a week for six weeks, supplemented by a home plan for the remaining three days. The control group received conventional therapy, including proprioceptive neuromuscular facilitation (PNF) and electrical interventions, also for four days a week, with a home plan for the remaining days. Key outcome measures were the Berg Balance Scale (BBS) for balance and the Fugl-Meyer Assessment for functional recovery. Data were analyzed using SPSS Version 25, with significance set at p&lt;0.05. Results: The Mirror Therapy group showed significantly greater improvements in balance scores, with a mean BBS of 40.31 at week 6 compared to 36.78 in the Conventional+KTR group (p&lt;0.001). Functional recovery was more pronounced in the Conventional+KTR group, which had a mean Fugl-Meyer Assessment score of 35.63 at week 6 compared to 30.50 in the Mirror Therapy group (p&lt;0.001). Gender distribution was similar across both groups, with the Conventional+KTR group consisting of 21.9% males and 78.1% females, and the Mirror Therapy group having 18.8% males and 81.3% females. Conclusion: Mirror therapy significantly enhances postural and kinesthetic rehabilitation in subacute stroke patients, particularly in improving balance more effectively than Conventional+KTR therapy. Conversely, Conventional+KTR therapy showed better results in functional recovery. These findings suggest that mirror therapy can be a valuable addition to stroke rehabilitation programs, offering a potential avenue for improved patient outcomes. Keywords: Mirror Therapy, Subacute Stroke Rehabilitation, Gait Improvement, Postural Awareness, Kinesthetic Awareness, Berg Balance Scale, Fugl-Meyer Assessment, Randomized Controlled Trial, Stroke Recovery, Balance Rehabilitation.

Comparison Between Mirror Therapy and Mental Imagery in Improving Ankle Motor Recovery in Acute Stroke Patients: Experimental Study

Introduction: Stroke is the sudden loss of neurological function caused by an interruption of the blood flow to the brain. Initially, some 80% of all patients with stroke experience motor impairments of the contralateral limb, i.e hemiparesis. Mirror therapy is relatively new therapeutic intervention that focuses on moving the unimpaired limb. Likewise, another technique called Mental imagery is the cognitive rehearsal of a task in the absence of movement. Aim and Objectives: To compare mirror therapy and mental imagery in improving ankle motor recovery in acute stroke patients. Methodology: 30 stroke patients were selected in the study, and were randomly assigned into two groups. Group A i.e. Mirror Therapy group (n=15) or the Group B i.e. Mental Imagery group (n=15). Both the groups received 30 minutes of their respective therapy that is mirror therapy and mental imagery and in addition to 30 minutes of conventional therapy which included neuro developmental facilitation technique, stretching, gait training that is a total of 1 hour per day for 5 days a week for 4 weeks. Modified Ashworth Scale, 10 Meter Walk test (10MWT), Fugl-Meyer assessment Lower extremity (FMA-LE) scale were administered pre and post intervention to assess the ankle motor function. Results: Only Fugl Meyer Assessment scores on comparison between Group A (Mirror Therapy) and Group B (Mental Imagery) revealed that statistically significant improvement was found in Group B (Mental Imagery) (t-value: 2.140; p-value: .041*). Conclusion: The present study concluded that Mental Imagery proved to be more effective than Mirror Therapy in improving ankle motor recovery in acute stroke patients.

Efficacy of mirror therapy in improving hand function post flexor tendon repair

The aim of this study was to determine the efficacy of mirror therapy (MT) in improving the total active range of motion (AROM) of the affected finger, hand grip strength, and hand function in patients with flexor tendon repair (FTR) in zone II. The study was an open-label, parallel-group, randomized controlled trial. Thirty patients with zone II FTR, aged 20-45 years, were recruited and randomized into two equal groups: the MT group and the sham MT group. The intervention began in the fourth week post-operation, consisting of thirty minutes of MT or sham MT, three sessions per week for four weeks, in addition to the traditional physical therapy (PT) program. The total AROM of the interphalangeal (IP) joints of the affected fingers, hand grip strength, and hand function were assessed. After four weeks of intervention, the percentage change in total AROM was 25.7% in the MT group and 19.93% in the sham MT group. Additionally, hand grip strength and Michigan Hand Outcomes Questionnaire (MHQ) scores showed greater improvement in the MT group compared to the sham MT group (p &lt; 0.05). Adding MT to the traditional PT program may be more effective than the traditional PT program alone in improving the AROM of the interphalangeal (IP) joints of the operated fingers, grip strength, and MHQ scores.

Effect of Home-Based Task-Based Mirror Therapy on Upper Extremity Function in Stroke Patients: A Four-Week Intervention Study

Objective: This study aimed to investigate the effect of task-based mirror therapy on upper extremity function, and daily living activities in individuals with stroke, after four weeks of training. Material and Methods: Participants were randomized into two groups, the task-based mirror therapy group and the task training as the control group: as 10 and 7 participants, respectively. The Action Research Arm Test (ARAT), the Fugl-Meyer Assessment (FMA), the Sirindhorn National Medical Rehabilitation Center Functional Assessment (SNMRC) and the Short-Form 36 (SF-36) were assessed before and after training, over a four week period. Results: The results showed that the home-based programs of both the task-based mirror therapy and the control group improved on all variables, but without statistical significance between groups. However, within group analysis, the task-based mirror therapy group exhibited significant differences between pre- and post-assessments for FMA; whereas, the control group did not. Conclusion: The home-based program of task-based mirror therapy, as a task-specific training approach, has demonstrated the potential to enhance the recovery of upper limb motor function after a four-week training period.

Evidence of mirror therapy for recruitment of ipsilateral motor pathways in stroke recovery: A resting fMRI study

Mirror therapy (MT) has been proposed to promote motor recovery post-stroke through activation of mirror neuron system, recruitment of ipsilateral motor pathways, or/and increasing attention toward the affected limb. However, neuroimaging evidence for these mechanisms is still lacking. To uncover the underlying mechanisms, we designed a randomized controlled study and used a voxel-based whole-brain analysis of resting-state fMRI to explore the brain reorganizations induced by MT. Thirty-five stroke patients were randomized to an MT group (n ​= ​16) and a conventional therapy (CT) group (n ​= ​19) for a 4-week intervention. Before and after the intervention, the Fugl-Meyer Assessment Upper Limb subscale (FMA-UL) and resting-state fMRI were collected. A healthy cohort (n ​= ​16) was established for fMRI comparison. The changes in fractional amplitude of low-frequency fluctuation (fALFF) and seed-based functional connectivity were analyzed to investigate the impact of intervention. Results showed that greater FMA-UL improvement in the MT group was associated with the compensatory increase of fALFF in the contralesional precentral gyrus (M1) region and the re-establishment of functional connectivity between the bilateral M1 regions, which facilitate motor signals transmission via the ipsilateral motor pathways from the ipsilesional M1, contralesional M1, to the affected limb. A step-wise linear regression model revealed these two brain reorganization patterns collaboratively contributed to FMA-UL improvement. In conclusion, MT achieved motor rehabilitation primarily by recruitment of the ipsilateral motor pathways. Trial Registration Information: http://www.chictr.org.cn. Unique Identifier. ChiCTR-INR-17013644, submitted on December 2, 2017.

The effect of mirror therapy in the rehabilitation of flexor tendon injuries after primary surgical repair

ObjectiveThe 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 methodsThirty 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. ResultsMore 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). ConclusionThis 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.

Augmented Visual Feedback for Complex Motor Skill Acquisition: A Demonstration with Healthy Young Adults.

Mirror therapy (MT) is a treatment for improving motor function after stroke. Video therapy (VT) training combines observation and imitation of video clips, and it has been used to conduct efficient occupational therapy. We sought to determine the effects of MT and VT on tool-use with healthy young adults. We assigned participants to three different training groups in which they used their non-dominant left hands to move a ball with chopsticks: (a) a self-paced MT group (N = 14), (b) an MT group who moved the ball while looking at the mirror image of the right hand with a sound cue (4-second intervals) (N = 12), and (c) a group who imitated a video demonstration (4-second intervals) (N = 13). The ball-moving time was significantly reduced after training in all three groups: MT group (p < .001), MT-R group (p = .010), and VT group (p = .014), but the video group showed significantly greater relative improvements in motion variability (p = .030) and object prediction (p = .008).We concluded that MT was as effective as VT in improving movement speed, but, with these healthy young adults, MT was less effective than VT in learning speed control or hand pre-shaping to refine task movements for tool use.

Measuring the Potential Effects of Mirror Therapy Added to the Gold Standard Facial Neuromuscular Retraining in Patients With Chronic Peripheral Facial Palsy: Protocol for a Randomized Controlled Trial.

Facial neuromuscular retraining (fNMR) is a noninvasive physical therapy widely used to treat peripheral facial palsies. It consists of different intervention methods that aim to reduce the debilitating sequelae of the disease. Recently, the use of mirror therapy in the acute facial palsy and postsurgical rehabilitation contexts has shown promising results, suggesting its use as an adjunct to fNMR in treating patients with later stages of paralysis, such as the paretic, early, or chronic synkinetic. The main aim of this study is to compare the efficacy of an added mirror therapy component with fNMR in patients with peripheral facial palsy (PFP) sequelae in 3 different stages. The specific objectives of this study are to measure the effects of combined therapy compared to fNMR alone on (1) participants' facial symmetry and synkinesis, (2) quality of life and psychological aspects of the participants, (3) motivation and treatment adherence, and (4) different stages of facial palsies. This study is a randomized controlled trial that compares the effect of fNMR combined with mirror therapy (experimental group: n=45) with fNMR alone (control group: n=45) in 90 patients with peripheral facial palsy presenting with sequelae 3-12 months after onset. Both groups will receive 6 months of rehabilitation training. Facial symmetry and synkinesis; participants' quality of life; and their psychological factors, motivation, and compliance will be assessed at baseline (T0), 3 months (T1), 6 months (T2), and 12 months (T3) postintervention. Outcome measures are (1) changes in facial symmetry and synkinesis assessed with facial grading tools, (2) quality of life changes with patient questionnaires, and (3) therapy motivation with a standardized scale, as well as adherence to treatment with metadata. Changes in facial symmetry and synkinesis will be judged by 3 assessors blinded to group assignment. Mixed models and Kruskal-Wallis, chi-square, and multilevel analyses will be conducted according to the appropriate variable type. Inclusion will start in 2024 and is anticipated to be completed in 2027. The 12-month follow-up will be completed with the last patient in 2028. We expect patients included in this study to experience improvement in facial symmetry, synkinesis, and quality of life, regardless of group assignments. A potential benefit of mirror therapy for facial symmetry and synkinesis could be noted for patients in the paretic phase. We hypothesize better motivation and adherence to treatment for the mirror therapy group. The results of this trial may provide new guidelines for PFP rehabilitation with patients dealing with long-term sequelae. It also fills the need for robust evidence-based data in behavioral facial rehabilitation. PRR1-10.2196/47709.

Immediate Effect of Mirror Therapy Using Pegboard Training on Hand Function and Muscle Activities in Individuals With Asymmetrical Hand Function

Objectives: A proper function of hands is critical for doing daily activities and work, especially when using electronic devices. This study determined the effect of mirror therapy on individuals with asymmetrical hand function. Methods: Forty-two men with asymmetrical hand function were recruited. All participants were randomly divided into sham control (n=21) and mirror therapy (n=21) groups. Both groups were tested before and after training using the 9-hole peg test (9HPT). The sham control group received pegboard training, and the mirror therapy group received mirror therapy using the pegboard. During training, hand muscle activities were recorded using surface electromyography. The obtained data were analyzed using the t-test and Mann-Whitney U test. Results: Non-dominant hand function on the 9HPT showed significant improvement in the mirror therapy group compared with the sham control group (P=0.021). The asymmetric hand function was also improved in the mirror therapy group. Muscle activities of the non-dominant hand were not significantly different between groups. Discussion: Mirror therapy using the pegboard had an immediate effect on improving non-dominant hand function. This finding has implications for possible preventive strategies against common hand problems and improving the efficient use of both hands.

Assessment of efficiency of mirror therapy in preventing phantom limb pain in patients undergoing below-knee amputation surgery-a randomized clinical trial.

Phantom limb pain (PLP) is a major cause of physical limitation and disability accounting for about 85% of amputated patients. Mirror therapy is used as a therapeutic modality for patients with phantom limb pain. Primary objective was to study the incidence of PLP at 6months following below-knee amputation between the mirror therapy group and control group. Patients posted for below-knee amputation surgery were randomized into two groups. Patients allocated to group M received mirror therapy in post-operative period. Two sessions of therapy were given per day for 7days and each session lasted for 20min. Patients who developed pain from the missing portion of the amputated limb were considered to have PLP. All patients were followed up for six months and the time of occurrence of PLP and intensity of the pain were recorded among other demographic factors. A total of 120 patients completed the study after recruitment. The demographic parameters were comparable between the two groups. Overall incidence of phantom limb pain was significantly higher in the control group (Group C) when compared to the mirror therapy (Group M) group [Group M = 7 (11.7%) vs Group C = 17 (28.3%); p = 0.022]. Intensity of PLP measured on the Numerical Rating Scale (NRS) was significantly lower at 3months in Group M compared to Group C among patients who developed PLP [NRS-median (Inter quartile range): Group M 5 (4,5) vs Group C 6 (5,6); p 0.001]. Mirror therapy reduced the incidence of phantom limb pain when administered pre-emptively in patients undergoing amputation surgeries. The severity of the pain was also found to be lower at 3months in patients who received pre-emptive mirror therapy. This prospective study was registered in the clinical trial registry of India. CTRI/2020/07/026488.

Is mirror therapy combined with a routine physiotherapy protocol effective for children with obstetrical upper brachial plexus palsy?

Study designRandomized controlled study. IntroductionMirror therapy is a rehabilitation strategy based on the repeated use of the mirror illusion and also one of the treatment choice of brachial plexus injuries. PurposeWe aimed to determine the effects of mirror therapy combined with a routine rehabilitation program on upper limb motor function in children with obstetric brachial plexus injury. MethodsTwenty children with obstetric brachial palsy were included in this study. They were randomly allocated to either control (n = 10) or mirror therapy (n = 10) group. The following clinical tools were used to assess the upper extremity function: Active Movement Scale (AMS), Modified Mallet Scale (MMS), Hand Grip Strength (HGS) Test, Finger Grip Strength (FGSM) Test, Box and Block Test (BBT), Nine Hole Peg Test (9-HPT), and goniometric measurement. Both groups received the same routine physiotherapy program for 8 weeks. The study group underwent mirror therapy in addition to the rehabilitation program. ResultsThe mean age of the study population was 11.35 ± 4.12 years. There was no change in the goniometric values, AMS and MMS scores after the treatment in both groups (p > 0.05), except for the improvement of the wrist extension in the study group (p < 0.05). There was an increase in both HGS and FGS scores in the study group. Only FGS scores improved in the control group after the intervention (p < 0.05). 9-HPT and BBT scores improved in both groups (p < 0.05). All other parameters tested were comparable between the two groups after the treatment. ConclusionsThe results of this study did not show any additional benefits of mirror therapy combined with a rehabilitation protocol compared to routine physiotherapy treatment, but was not adequately powered to do so.

Effect Of Thermal Stimulation And Mirror Therapy On Hand Functions In Patients With Stroke: An Interventional Study

&#x0D; Background: Thermal stimulation can be used as an intervention to enhance sensory function. Activated areas by thermal stimulation are greater than those by tactile or mechanical stimulation. Mirror therapy creates the illusion of normal movement with the mirror image of the unaffected upper extremity. Thermal stimulation provides somatosensory stimulation that causes the forced use of the involved extremity as a protective response to heat which provokes volitional/reflexive motor activity. Somatosensory stimulation may induce brain plasticity.&#x0D; Purpose: This study was carried out to determine the effect of thermal stimulation and mirror therapy in the sensorimotor and functional recovery of hand in stroke patients with hand impairment.&#x0D; Methods: 18 stroke survivors were randomly assigned to Thermal Stimulation rehabilitation treatment and Mirror Therapy rehabilitation group (30 minutes daily for 3 weeks). Three measures, including Brunnstorm stage, Wolf motor Function Test, and Revised Nottingham Sensory Assessment scale was used as an outcome measure to assess the motor and sensory recovery.&#x0D; &#x0D; &#x0D; &#x0D; Results: The Thermal Stimulation group showed a potential trend for improved recovery stage as measured by Brunnstorm staging for motor recovery of hand as compared to the Mirror therapy group. The Thermal Stimulation group also showed a statistically significant and large improvement in tactile, proprioception and stereognosis score as measured by Revised Nottingham sensory assessment scale whereas Mirror Therapy group showed significant improvement in stereognosis score alone.&#x0D; &#x0D; &#x0D; &#x0D; Conclusion: Thermal stimulation has more positive effect in the sensorimotor and functional recovery of hand in acute stroke patients with hand impairment within 3 weeks in comparison to Mirror Therapy. Thermal stimulation protocol should be added in the clinical setting of rehabilitation in stroke patients with hand impairment on the basis of the result of this study.&#x0D;

Examining the Effects of Mirror Therapy on Psychological Readiness and Perception of Pain in ACL-Injured Female Football Players.

Virtual reality-guided imagery (VRGI) and mirror therapy (MT) have been used in isolation to treat patients suffering from different injuries. However, no attempts have been made to understand the effects of combined VRGI and MT added to conventional physical therapy, and no information exists regarding perceptual responses to these rehabilitation strategies in female football players. Thus, this study aimed to examine the effect of MT added to conventional rehabilitation on psychological readiness and perception of pain in ACL-injured female football players. Thirty ACL-injured female football players competing in the 2nd and 3rd Italian tier who underwent an ACL rehabilitation program from the same clinic participated in this study. Players were randomly distributed in an MT group (n = 15) and a CON group (n = 15). All participants reported their perception of pain on a VAS before and after the interventions and their psychological readiness to return to sport after ACL injury and reconstruction surgery on the ACL-RSI scale after the intervention. An independent-sample t-test was performed to assess between-group differences in post-intervention ACL-RSI, and a further independent-sample t-test to assume non-significant differences between VAS values before the intervention. A two-way repeated-measures analysis of variance was used to test the null hypothesis of no different change in VAS over time between groups. After the intervention, the MT group perceived largely greater psychological readiness (p &lt; 0.01). MT and CON groups experienced a large reduction in VAS after the intervention (p &lt; 0.001). However, a small time × group interaction was observed (p = 0.023). MT reported a greater perception of the psychological readiness of the soccer players and a lower perception of pain than those who performed conventional therapy.

Mirror therapy effect on shoulder pain and disability and quality of life of mastectomy women: a randomized clinical trial

PurposeTo investigate mirror therapy (MT) influence on shoulder pain/disability and quality of life in mastectomy women.Materials and methodsSixty unilateral mastectomy women were recruited and randomly assigned to an MT group (N = 30) or a sham therapy (ST) (N = 30). Women in the MT and ST group attended a nurse-led, unsupervised, 30 min a day, five days a week, and at home training program for three weeks with and without a mirror, respectively. Shoulder pain and disability scale and QOL outcomes were assessed at baseline and 3 months after intervention.ResultsShoulder pain and disability were significantly improved in the MT group but there was not meaningful difference between groups in the EORTC-QOL scales except for some functional scores of QLQ-BR23 scale in the MT group after 3 months follow-up.ConclusionsNurses should instruct MT as a rehabilitation program to mastectomy patients during or after hospitalization to reduce their post-op shoulder pain and disability. This intervention may have also positive impact on their self-care outcomes. It is recommended that further studies should be performed with nurse-supervised exercises, a validated tool for measuring QOL for a long period after surgery, and a longer follow-up period at least for 6 months.Implication for rehabilitationThis study aimed to investigate whether an unsupervised, nurse-led mirror therapy (MT) can alleviate shoulder pain and disability of mastectomy patients and improve their quality of life.Our findings indicated that nurse-led MT as a novel rehabilitation option for mastectomy patients, may reduce shoulder pain and disability even after long period after the surgery.Rehabilitation centers can equip rooms for MT so breast cancer women can use it immediately after mastectomy.Mirror therapy can be used as a rehabilitation method for mastectomy patients because it is easy-to-use, inexpensive, and without the need to attend a rehabilitation center.Rehabilitation centers can provide mirrors along with nursing instructions to women who want to use this method at home.

Proprioceptive Neuromuscular Facilitation and Mirror Therapy Methods Are Comparable Methods of Rehabilitation after a First-Ever Ischemic Stroke: A Randomized Study

Stroke is a serious cause of premature death among adults and the reason for much long-term disability. Understanding the mechanisms of disability and the potential for recovery of stroke patients should be one of the highest priorities of the health care system. Neurorehabilitation of post-stroke patients focuses on functional recovery by activating mechanisms of natural reorganization. Proprioceptive neuromuscular facilitation (PNF) and mirror therapy (MT) are neurorehabilitation methods activating brain plasticity, and their clinical utility for stroke survivors is still under studied. This study compared two neurorehabilitation methods using PNF or MT on functional recovery in patients after a first-ever ischemic stroke. This prospective and interventional randomized clinical study involved a group of 50 patients (34 males and 16 females) with first-ever ischemic stroke, aged 48–82 years being in the recovery-compensation stage and admitted to the unit for early post-stroke rehabilitation. Patients were randomly enrolled into two groups in terms of rehabilitation method used: PNF (n = 26) or MT (n = 24). Barthel Index (BI) was used for assessing functional status at baseline (M0), and 3 (M1) and 6 weeks (M2) after intervention), and modified Rankin Scale (mRS) was used for assessing a disability level at baseline (M0), and 6 weeks (M2) after the intervention. Statistically significant differences were noted in the two study groups in BI (main effect: &lt;0.05). There was an improvement in the MT group between M1 and M2 by 3.6 points, M1 and M3 by 6.9 points, and M2 and M3 by 6.9 points. For the PNF group, there were differences between M1 and M2 by 4.1 points, M1 and M3 by 7.2 points, and M2 and M3 by 3.1 points. Moreover, statistically significant differences were noted in both groups in mRS (main effect: p &lt; 0.05). There was a decrease of 2.2 points in the MT group between M1 and M2 measurements. For the PNF group, there were differences between M1 and M2 by 2.3 points. There were no statistically significant differences between the MT and PNF groups in both BI and mRS scores (p &lt; 0.05). In conclusion, both PNF and MT neurorehabilitation methods could be useful for improving functional status and reducing disability level in patients after first-ever stroke during the regenerative-compensatory stage.

The effect of mirror therapy on joint movement, pain and functionality in acute upper limb burns

ObjectiveMirror therapy is aimed at developing a normal proprioceptive perception for the area with pain or movement restriction by making use of the person's monitoring of the healthy side movements thanks to the mirror's reflective feature. The aim of this study is to investigate the effect of mirror therapy on joint range of motion, pain and functionality in acute upper extremity burn injuries. MethodsDemographic and burn-specific data of individuals with upper extremity burns were recorded. Individuals were divided into two groups. Standard treatment was applied to the first group, and mirror treatment in addition to the standard treatment was applied to the second group for 30 sessions, 5 days a week for 6 weeks. In the standard treatment program, passive, active-assisted and active ROM, strengthening, stretching, resistant and functional exercises were applied. In the mirror therapy group, active exercises were performed on the healthy side by covering the burn area in the mirror box. Before and after the treatment, joint range of motion(ROM) was evaluated with Universal Goniometer, pain intensity was evaluated with Visual Analog Scale and upper extremity functions were evaluated with QuickDASH. ResultsA total of 32 (23 Male, 9 Female) individuals between the ages of 18–65 were included. The mean total burn surface area was 12.93 ± 9.80 in the standard treatment and 6.12 ± 2.96 in the mirror treatment. The groups were similar in terms of ROM change (p > 0.05). The pretest/posttest pain scores of both the standard therapy and mirror therapy groups were similar (p > 0.05). There was no statistically significant difference in terms of pretest and posttest QuickDASH scores according to the groups (p > 0.05). The difference between the pretest/posttest QuickDASH scores of both Standard treatment and Mirror treatment groups was statistically significant. ConclusionThis study showed that the standard physiotherapy and rehabilitation program applied in the acute period in upper extremity burns and the mirror treatment applied in addition to this program provide similar improvements in joint range of motion and pain.

Effectiveness of robot-assisted virtual reality mirror therapy for upper limb motor dysfunction after stroke: study protocol for a single-center randomized controlled clinical trial

BackgroundUpper limb motor dysfunction is a common sequela of stroke, and its clinical efficacy needs to be improved. This protocol describes a trial to verify the clinical efficacy of robot-assisted virtual reality mirror therapy (RAVRMT) in improving upper limb motor dysfunction in stroke patients, and to explore the central mechanism by using functional magnetic resonance imaging (fMRI).MethodsThis trial will be a single-center, assessor-blinded, randomized controlled clinical study. Thirty-two eligible patients will be randomly divided into 2 groups according to the ratio of 1:1, namely virtual reality mirror therapy (VRMT) group and robot-assisted virtual reality mirror therapy (RAVRMT) group. The interventions will be performed once a day for 4 weeks. Primary outcome is Fugl–Meyer motor function assessment-Upper Extremity (FMA-UE), secondary outcomes are the Montreal Cognitive Assessment (MoCA), activities of daily living (ADL), quality of life (QOL), the pain visual analogue scale (VAS-pain) and fMRI. Adverse events will be recorded, and severe adverse events will be used as criteria to discontinue the intervention.DiscussionCombined application of robot-assisted therapy and virtual reality mirror therapy could theoretically activate mirror neuron system and reward circuits to a greater extent, but further high-quality research is needed. The results of this trial will determine whether RAVRMT could better improve upper limb motor dysfunction after stroke and explore its central mechanism using fMRI.Trial registrationThis trial was prospectively registered at ClinicalTrials.gov (ChiCTR2200061721; 01 July 2022).