Mirror Therapy Research Articles

Electroencephalogram Alpha Oscillations in Stroke Recovery: Insights into Neural Mechanisms from Combined Transcranial Direct Current Stimulation and Mirror Therapy in Relation to Activities of Daily Life.

The goal of stroke rehabilitation is to establish a robust protocol for patients to live independently in community. Firstly, we examined the impact of 3 hybridized transcranial direct current stimulation (tDCS)-mirror therapy interventions on activities of daily life (ADL) in stroke patients. Secondly, we explored the underlying therapeutic mechanisms with theory-driven electroencephalography (EEG) indexes in the alpha band. This was achieved by identifying the unique contributions of alpha power in motor production to ADL in relation to the premotor cortex (PMC), primary cortex (M1), and Sham tDCS with mirror therapy. The results showed that, although post-intervention ADL improvement was comparable among the three tDCS groups, one of the EEG indexes differentiated the interventions. Neural-behavioral correlation analyses revealed that different types of ADL improvements consistently corresponded with alpha power in the temporal lobe exclusively in the PMC tDCS group (all rs > 0.39). By contrast, alterations in alpha power in the central-frontal region were found to vary, with ADL primarily in the M1 tDCS group (r = -0.6 or 0.7), with the benefit depending on the complexity of the ADL. In conclusion, this research suggested two potential therapeutic mechanisms and demonstrated the additive benefits of introducing theory-driven neural indexes in explaining ADL.

Visual effects on tactile stimulation and its perception: A pilot study using near-infrared spectroscopy

In rubber hand illusion, visual information affects tactile information, whereas in the mirror box illusion, visual information has the opposite effect. However, its underlying mechanisms are not fully understood. As one of the reasons, non-invasive neuroimaging techniques, such as functional magnetic resonance, positron emission tomography, and electroencephalography, often fail to detect complex and fragile responses in the sensory-motor cortex. Using near-infrared spectroscopy (NIRS), we examined neural activity during tactile tracing on a sine-shaped acrylic board to investigate the effects of (1) visual information and (2) the spatial frequency of the sine shape on brain activity. We used spatial frequencies of 2–3 and 20–30 Hz as low- and high-tactile stimuli, respectively. Two types of experiments, with and without an acrylic board, were conducted. Participants performed the tracing tasks with their index finger at 1 Hz of temporal frequency of a 200 mm length of the acrylic board as main tasks and only space moving without touching as a control task. We show effect of visual information on neural activation, including not only activation intensity but also activation patterns.•Testing of mutual effects of vision and haptics.•Testing of sensory-motor paradox using NIRS.•A high NIRS sensitivity to stimulus-induced hemodynamic change.

Effect of interactive scalp acupuncture on upper limb function in patients with hemiplegia after stroke

To explore the clinical effect of interactive scalp acupuncture combined with task-oriented mirror therapy on hemiplegia after stroke. A total of 86 patients with hemiplegia after stroke were randomly divided into an observation group (43 cases, 2 cases dropped out) and a control group (43 cases, 2 cases dropped out). Both groups received routine treatment and rehabilitation treatment for stroke. The control group was treated with task-oriented mirror therapy, 40 min each time, once a day, 6 days a week. The observation group was treated with interactive scalp acupuncture at ipsilateral upper 1/5 and 2/5 of the parietal and temporal anterior oblique line and upper 1/5 and 2/5 of the parietal and temporal posterior oblique line on the basis of the treatment as the control group, 45 min each time, once a day, 6 days a week. Both groups were treated for 4 weeks. Before and after treatment and in follow-up of 8 weeks after treatment completion, the Fugl-Meyer assessment (FMA) score, modified Ashworth scale (MAS) score, shoulder abduction angle, wrist dorsiflexion angle and N20 latency and amplitude of somatosensory evoked potential were compared between the two groups. After treatment and in follow-up, the FMA scores were increased (P<0.01), the MAS scores were decreased (P<0.01) compared with those before treatment in the two groups; the FMA scores in the observation group were higher than those in the control group (P<0.01), the MAS scores were lower than those in the control group (P<0.01). After treatment and in follow-up, the shoulder abduction angle and wrist dorsiflexion angle was increased (P<0.01), the N20 latency was shortened and amplitude was increased (P<0.01) compared with that before treatment in both groups; the shoulder abduction angle and wrist dorsiflexion angle in the observation group was greater than that in the control group (P<0.01), the N20 latency was shorter than that in the control group (P<0.01), and the N20 amplitude was higher than that in the control group (P<0.01). Interactive scalp acupuncture combined with task-oriented mirror therapy can improve upper limb function in patients with hemiplegia after stroke, and reduce the muscular tone of the affected limb.

Assessment of Stroke Patients' Muscle Strength Following a Combination of Mirror Therapy and ROM (Range of Motion) Exercises Based on Self-Care Theory

Background: When blood flow problems kill off some brain cells, the result is a neurological deficiency known as a stroke. There have been 507 reported cases of stroke in East Java, while the overall stroke prevalence in Indonesia has jumped from 7% to 10.9% (Riskesdas, 2020). The researchers at RSI Darus Syifa's Surabaya set out to determine how much of an impact self-care theory-based mirror therapy and range-of-motion exercises had on the muscular strength of stroke patients admitted to the inpatient unit. Methods: A true experimental with a pretest-posttest control group design was utilised in this type of research. One hundred and ten stroke patients made up the study's population. There were a total of 34 participants in this study, with 17 serving as control subjects and 17 as interventionists. Sampling was based on probability sampling using simple random sampling. The Medical Research Council (MRC) scale was utilised by the device to measure muscular strength. Mann-Whitney and the Wilcoxon Signet Rank Test were used to examine the collected data. Results: In the inpatient ward of the Darus Syifa Surabaya Hospital, stroke patients who undergo a combination of mirror therapy and range of motion exercises based on self-care theory show a significant improvement in muscle strength, according to the Mann-Whitney test (p &lt; 0.05). Conclusion: The study found that stroke patients' muscle strength improved with a combination of mirror therapy and range of motion exercises grounded in self-care theory.

Effects of Brunnstrom movement therapy versus mirror therapy on hand function in post-stroke hemiplegic population

Objectives: The objective of this study was to compare the effects of Brunnstrom movement therapy and mirror therapy (MT) on hand function in the post-stroke hemiplegic population. Methods: This randomized control pilot trial was conducted at District Headquarters Hospital and Rafiqa Hospital Sargodah, Pakistan in 2022. A total of 26 stroke patients having spastic hands aged 40–70 were randomized into two groups. Group A was treated with Brunnstrom movement therapy along with conventional treatment. Group B was treated with MT and conventional treatment. Fugl-Meyer assessment: wrist and hand subtest (items VII, VIII, and IX) and Brunnstrom hand manipulation were used to assess outcome measures. Results: Twenty-six patients of both sexes, 13 in each group. The mean age in Group A was 58.30 ± 7.53, and Group B’s was 57.46 ± 8.40. Brunnstrom movement and MT scores showed a statistically significant difference within a group (P &lt; 0.05). The between-group comparison showed a statistically significant difference (P &lt; 0.05). Between-group comparison of results showed marked improvement in Fugl-Meyer in the case of Brunnstrom movement therapy compared to MT. Conclusion: This study concluded that stroke patients treated with Brunnstrom movement therapy showed more improvement in hand functioning and activities of daily living than those treated with MT.

Action observation therapy impact on mirror neurons combined with acupuncture for upper limb motor impairment rehabilitation in stroke patients

Abstract: OBJECTIVE: Upper limb (UL) dysfunction rehabilitation in stroke patients is complicated in the clinic. Action observation therapy’s (AOT) impact on mirror neurons (MNs) has been observed and made applications in related brain disease treatment. Acupuncture mentioned in the present study mainly stimulates peripheral nerves for neuronal plasticity. However, the clinical effect of AOT impact on MNs and acupuncture irritate afferent nerve fibers in combination for UL motor impairment rehabilitation after stroke is still unclear. In the present study, we investigate the central and peripheral neural stimulation meanwhile for UL recovery with stroke patients. METHODS: In this clinical study, 82 stroke patients recruited with impaired UL were randomly assigned to three groups. Twenty-four cases were in the AOT group, 28 cases were in the AOT combined acupuncture treatment group, and 30 cases were in the acupuncture treatment group. All volunteers were scored for limb function through the Fugl–Meyer Assessment of the Upper Extremity (FMA-UE), the Action Research Arm Test, and the modified Barthel Index (BI) before and after a systematic treatment according to the groups. Meanwhile, conventional physical therapy was also implemented for all cases. RESULTS: Before the specific intervention, the scores of FMA-UE, FMA-UE, and BI with all stroke patients have no significant statistical difference (P &gt; 0.05). After the corresponding treatment, we assessed UL function again at 4 and 8 weeks. At 4 weeks, the patients with AOT showed a significant increase in BI scores compared to the acupuncture group (P &lt; 0.05). At 8 weeks, the FMA-UE scores of the patients with AOT combined with acupuncture were significantly increased than acupuncture alone (P &lt; 0.05). We also observed that the BI scores of the combination and the AOT group both were improved compared to the acupuncture group with significant statistical analysis (P &lt; 0.05). CONCLUSIONS: Based on the MNs theory, we adopted AOT impact on MNs which would be a promising rehabilitation technique, especially combined with acupuncture treatment in UL recovery of stroke. Mirror therapy seems to be effective for central neuronal plasticity, but for action or AOT, there is still insufficient evidence to recommend its optimal strategy and neuromodulation mechanism. Here, research on the MNs-based AOT technique with acupuncture in UL dysfunction with stroke patients is recommended. TRIAL REGISTRATION: http://www.chictr.org.cn (identifier: ChiCTR2300077010).

The Effectiveness of Exercises Based Mirror Therapy on Functional Activity of the Limbs among Stroke Patients.

The Effectiveness of Exercises Based Mirror Therapy on Functional Activity of the Limbs among Stroke Patients.

Acupuncture combined with mirror therapy for post-stroke dyskinesia: A meta-analysis and systematic review.

Dyskinesia is one of the most common complications of stroke. Acupuncture therapy (AT) and mirror therapy (MT) are promising rehabilitation measures for the treatment of post-stroke dyskinesia. Although some studies suggested that AT and MT are effective and safe for dyskinesia, the effects, and safety remain uncertain due to lacking strong evidence. The purpose of this study is to investigate the efficacy and safety of AT combined with MT in the treatment of post-stroke dyskinesia. We searched the following databases: PubMed, Web of Science, Cochrane Library, EMBASE, Medline, China Knowledge Network, WANFANG, and China Biomedical Literature Database, from inception to 1 January 2023 to identify eligible studies. Total effective rate, the Fugl-Meyer assessment scale (FMA) upper and lower limb scores, modified Barthel index scores, Berg balance scale, modified Ashworth scale, and adverse reactions were adopted as outcome indicators. The Grading of Recommendations Assessment Development and Evaluation system was used by 2 independent reviewers to assess the quality of evidence for the outcome indicators included in the study. The statistical analysis was conducted by RevMan V.5.4 software. A total of 24 randomized controlled studies included 2133 patients with post-stroke dyskinesia were included. The total effective rate of AT combined with MT was more advantageous in the treatment of post-stroke dyskinesia (relative risk = 1.31, 95% confidence interval [CI] [1.22-1.42], Z = 6.96, P < .0001). AT combined with MT was more advantageous for FMA upper limb score (mean difference [MD] = 6.67, 95% CI [5.21-8.13], Z = 8.97, P < .00001) and FMA lower limb score (MD = 3.72, 95% CI [2.81-4.63], Z = 7.98, P < .00001). Meta-analysis showed that AT combined with MT for post-stroke dyskinesia had a more advantageous modified Barthel index score (MD = 9.51, 95% CI [7.44-11.58], Z = 9.01, P < .00001). AT combined with MT is effective in improving motor function and daily living ability of patients, especially in improving muscle spasms. However, these results should be regarded with caution given the low quality of evidence for the evaluation results.

The Effectiveness of Mirror Therapy on Muscle Strength Rehabilitation in Non-Haemorrhagic Stroke Patients: Literature Review

Background: Stroke remains one of the significant problems of long-term disability. Most stroke patients have difficulty performing daily activities due to paresis of the upper limbs, resulting in impaired activities of daily living (ADL) and decreased quality of life. The purpose of this literature review is to find out the Application of Mirror Therapy to Muscle Strength Rehabilitation in non-homorrhagic stroke Patients. Methods: The method used is literature review (PRISMA) using journal databases from PubMed, Science Direct, and Google Scholar in the range 2020-2024 with the keywords "Mirror Therapy", "Muscle Strength Rehabilitation," and "Non-Hemorrhagic Stroke" and stroke obtained as many as 1276 articles. Results: The search for articles according to the criteria and obtained 9 articles that are ready to be reviewed. These articles explain the application of mirror therapy to muscle strength rehabilitation in non-hemorrhagic stroke patients. Conclusion: It is hoped that patients with stroke will endeavor to control mirror therapy.

Performance-based Assistance Control for Upper Limb Robotic Mirror Therapy

Performance-based Assistance Control for Upper Limb Robotic Mirror Therapy

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.

How does combining physical therapy with transcranial direct stimulation improve upper-limb motor functions in patients with stroke? A theory perspective.

More than half of stroke survivors suffer from upper-limb dysfunction that persists years after stroke, negatively impacting patients' independence and, therefore, affecting their quality of life. Intense motor rehabilitation is required after a stroke to facilitate motor recovery. More importantly, finding new ways to maximize patients' motor recovery is a core goal of stroke rehabilitation. Thus, researchers have explored the potential benefits of combining the effects of non-invasive brain stimulation with physical therapy rehabilitation. Specifically, combining transcranial direct stimulation (tDCS) with neurorehabilitation interventions can boost the brain's responses to interventions and maximize the effects of rehabilitation to improve upper-limb recovery post-stroke. However, it is still unclear which modes of tDCS are optimal for upper-limb motor recovery in patients with stroke when combined with physical therapy interventions. Here, the authors review the existing literature suggesting combining physical therapy rehabilitation with tDCS can maximize patients' motor recovery using the Interhemispheric Competition Model in Stroke. The authors focus on two main rehabilitation paradigms, which are constraint-induced movement therapy (CIMT) and Mirror therapy with and without tDCS. The authors also discuss potential studies to elucidate further the benefit of using tDCS adjunct with these upper-limb rehabilitation paradigms and its effectiveness in patients with stroke, with the ultimate goal of maximizing patients' motor recovery.

Case Report: Callosal disconnection syndrome manifesting as mixed frontal-callosal-posterior alien hand syndrome following extensive corpus callosum infarct

Alien hand syndrome (AHS) is a rare neurological phenomenon first described by Van Vleuten over a century ago. The most widely recognized variants in literature are frontal, callosal, and posterior AHS. AHS due to the corpus callosum lesion can occur alone or as part of callosal disconnection syndrome (CDS). This report presents a unique CDS case manifesting clinical features from all three AHS variants, resulting from an extensive corpus callosum infarct. Our patient exhibited various clinical features from the three AHS variants, which include grasping, groping, and difficulty releasing objects from the hand (anterior); intermanual conflict (callosal); arm levitation, mild hemiparesis, and hemisensory loss (posterior). Additionally, the extensive disruption of the corpus callosal fibers produced neurological manifestations of CDS, such as cognitive impairment, ideomotor and constructional apraxia, behavioral disorder, and transcortical motor aphasia. We employed a range of rehabilitation interventions, such as mirror box therapy, limb restraint strategy, verbal cue training, cognitive behavioral therapy, bimanual hand training, speech and language therapy, and pharmacological treatment with clonazepam. The patient showed almost complete resolution of CDS and AHS features by nine months post-stroke Our case report highlights distinctive clinical variations of AHS and the challenging correlation between clinical manifestations and neuroanatomical substrates. Future studies are necessary to explore the intricate neural connections and the precise function of the corpus callosum. This can be achieved by combining comprehensive neuropsychological testing with diffusion tensor tractography studies. It is also essential to develop a validated tool to standardize AHS assessment. Finally, the scarcity of evidence in rehabilitation interventions necessitates further studies to address the wide knowledge gap in AHS and CDS management.

EFFECTIVENESS OF GRADED MOTOR IMAGERY IN MUSCULOSKELETAL DISORDERS: A REVIEW OF LITERATURE

ABSTRACT Musculoskeletal disorders pose a significant global health burden with a substantial impact on individuals and healthcare systems. Graded Motor Imagery (GMI) is a novel and emerging approach in musculoskeletal rehabilitation based on the principles of neuroplasticity. This literature review aimed to evaluate the available evidence for the efficacy of GMI in diverse musculoskeletal pathologies. GMI is a multicomponent rehabilitation strategy that includes laterality recognition, motor imagery, and mirror therapy. It is hypothesized that the overall GMI program aims to create neural adaptations, reduce pain, and reduce disability. This review evaluated the effects of GMI from Randomized Controlled Trials on pain reduction, pain-related disability, strength, physical function, and fear of movement. Keywords: Graded Motor Imagery (GMI), Neuroplasticity, Musculoskeletal rehabilitation, Pain reduction, Randomized Controlled Trials (RCTs).

Insights into optimizing phantom pain management: A human-centered approach to end-user perspectives.

This report explores and summarizes perspectives from end users on unmet needs in achieving optimal and effective phantom pain management through a human-centered design approach. To examine current strategies, pharmacological, nonpharmacological, surgical procedures, virtual reality, and mirror therapy, and the evidence supporting them, in the management of phantom limb pain. This study reviewed and analyzed transcripts acquired in nonresearch contexts from the Veterans Affairs Translational Education and Mentoring Center's commercialization training program and from a Veteran Engagement Panel. Key themes were extracted using quasi-qualitative analysis of one-on-one interviews. Clinicians and patients report that early patient intervention and education will yield improved management of phantom limb pain, which aligns with the growing recognition of the impact of patient-centered care on overall treatment outcomes. Mirror therapy is viewed as an effective and low-risk therapy, though compliance and buy-in may be barriers to clinical practice. Patient engagement can contribute to better treatment adherence and outcomes. The study highlights implementation barriers, importance of end-user input, and the role of the Veteran Engagement Panel in providing feedback to pain researchers. The findings help explain unaddressed challenges and areas requiring further research to direct phantom pain management.

A computer-aid speech rehabilitation system with mirrored video generating.

Aphasia is a communication disorder that affects the ability to process and produce language, which severely impacting their lives. Computer-aid exercise rehabilitation has shown to be highly effective for these patients. In our study, we proposed a speech rehabilitation system with mirrored therapy. The study goal is to construct a effective rehabilitation software for aphasia patients. This system collects patients' facial photos for mirrored video generation and speech synthesis. The visual feedback provided by the mirror creates an engaging and motivating experience for patients. And the evaluation platform employs machine learning technologies for assessing speech similarity. The sophisticated task-oriented rehabilitation training with mirror therapy is also presented for experiments performing. The performance of three tasks reaches the average scores of 83.9% for vowel exercises, 74.3% for word exercies and 77.8% for sentence training in real time. The user-friendly application system allows patients to carry out daily training tasks instructed by the therapists or the prompt information of menu. Our work demonstrated a promising intelligent mirror software system for reading-based aphasia rehabilitation.

The Use of Mirror Therapy in Peripheral Seventh Nerve Palsy: A Systematic Review.

Conservative therapy is currently the elective treatment for peripheric facial palsy according to scientific literature. The success of conservative therapy is due to physiotherapy and the application of its methods. The aim of this systematic review was to assess mirror therapy, a physiotherapeutic method. The aim of the following systematic review is to evaluate the effectiveness of using mirror therapy in patients with peripheral paralysis of the seventh cranial nerve. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The screening of literature was carried out on Cochrane, PEDro, PubMed/Medline, Scopus and Web of Science databases up until August 2022. All studies were randomized controlled trials (RCTs) and 5 articles met the inclusion criteria and were included in this study. The risk of bias was evaluated with PEDro and Jadad scales. In the present study, we reviewed 5 RCTs that compared mirror therapy with other physiotherapy treatments or placebo to reduce pain, depression and improve range of motion in patients with peripheric facial nerve palsy. Further studies are needed to determine the effectiveness of this type of treatment, but nevertheless the data obtained are very encouraging.

Responsiveness and construct validity of two outcome measures of bilateral upper limb function in patients with chronic stroke

BackgroundStroke is a leading cause of long-term disability among stroke survivors. Despite the availability of numerous stroke rehabilitative therapies, such as mirror therapy, bilateral arm training, and robot-assisted therapy, the recovery of motor function after stroke remains incomplete. Bilateral arm function is a key component in stroke patients to perform activities of daily living and to reflect their functional autonomy.ObjectiveThis clinimetric study investigated and compared the construct validity and responsiveness of 2 bimanual activity outcome measures, the Chedoke Arm and Hand Activity Inventory (CAHAI) and the ABILHAND Questionnaire, in individuals receiving stroke rehabilitation.MethodsThe present study is a secondary analysis following the framework of the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Individuals with chronic stroke (N = 113) were recruited from outpatient rehabilitation settings. Participants received 18 to 20 sessions of robot-assisted therapy, mirror therapy, combined therapy, or conventional rehabilitation for 4 to 6 weeks. The CAHAI, ABILHAND Questionnaire, and a comparison instrument, the Motor Activity Log (MAL), were administered twice at a 4- to 6-week interval to all participants. ABILHAND scores, in logits, were converted from raw ordinal scores into a linear measure.ResultsThere was medium to large correlation of the CAHAI and the MAL (ρ = 0.60–0.62, p &amp;lt; 0.01) as well as the ABILHAND Questionnaire and the MAL (ρ = 0.44–0.51, p &amp;lt; 0.01). Change scores from the initial measurement to the post-intervention measurement demonstrated small to medium correlation of the CAHAI and the MAL (ρ = 0.27–0.31, p &amp;lt; 0.01) and medium to large correlation of the ABILHAND Questionnaire and the MAL (ρ = 0.37–0.41, p &amp;lt; 0.01). Overall, 7 of 8 hypotheses were supported. The hypothesis testing regarding the construct validity and responsiveness of the CAHAI and ABILHAND Questionnaire was confirmed.ConclusionThe CAHAI and ABILHAND Questionnaire are both responsive and suitable to detect changes in bilateral arm functional daily activities in individuals with chronic stroke. Patient-reported outcome measures are recommended to use along with therapist-rated outcome measures for upper limb capacity evaluation in stroke rehabilitation. Further study with a prospective study design to capture specific clinical features of participants and the use of body-worn sensors, such as the arm accelerometer, is suggested.

Video mirror feedback induces more extensive brain activation compared to the mirror box: an fNIRS study in healthy adults

BackgroundMirror therapy (MT) has been shown to be effective for motor recovery of the upper limb after a stroke. The cerebral mechanisms of mirror therapy involve the precuneus, premotor cortex and primary motor cortex. Activation of the precuneus could be a marker of this effectiveness. MT has some limitations and video therapy (VT) tools are being developed to optimise MT. While the clinical superiority of these new tools remains to be demonstrated, comparing the cerebral mechanisms of these different modalities will provide a better understanding of the related neuroplasticity mechanisms.MethodsThirty-three right-handed healthy individuals were included in this study. Participants were equipped with a near-infrared spectroscopy headset covering the precuneus, the premotor cortex and the primary motor cortex of each hemisphere. Each participant performed 3 tasks: a MT task (right hand movement and left visual feedback), a VT task (left visual feedback only) and a control task (right hand movement only). Perception of illusion was rated for MT and VT by asking participants to rate the intensity using a visual analogue scale. The aim of this study was to compare brain activation during MT and VT. We also evaluated the correlation between the precuneus activation and the illusion quality of the visual mirrored feedback.ResultsWe found a greater activation of the precuneus contralateral to the visual feedback during VT than during MT. We also showed that activation of primary motor cortex and premotor cortex contralateral to visual feedback was more extensive in VT than in MT. Illusion perception was not correlated with precuneus activation.ConclusionVT led to greater activation of a parieto-frontal network than MT. This could result from a greater focus on visual feedback and a reduction in interhemispheric inhibition in VT because of the absence of an associated motor task. These results suggest that VT could promote neuroplasticity mechanisms in people with brain lesions more efficiently than MT.Clinical trial registrationNCT04738851.

Combined Effect of Non-Invasive Brain Stimulation with Mirror Therapy for Improving Motor Function in Patients with Stroke: a Systematic Review with Meta-Analysis

Combined Effect of Non-Invasive Brain Stimulation with Mirror Therapy for Improving Motor Function in Patients with Stroke: a Systematic Review with Meta-Analysis