Mirror Visual Feedback Research Articles

Cross-education Of The Repeated-bout Effect After Unilateral Eccentric Exercise With And Without Mirror Visual Feedback

Cross-education Of The Repeated-bout Effect After Unilateral Eccentric Exercise With And Without Mirror Visual Feedback

Neurophysiological Oscillatory Mechanisms Underlying the Effect of Mirror Visual Feedback-Induced Illusion of Hand Movements on Nociception and Cortical Activation.

Mirror Visual Feedback (MVF)-induced illusion of hand movements produces beneficial effects in patients with chronic pain. However, neurophysiological mechanisms underlying these effects are poorly known. In this preliminary study, we test the novel hypothesis that such an MVF-induced movement illusion may exert its effects by changing the activity in midline cortical areas associated with pain processing. Electrical stimuli with individually fixed intensity were applied to the left hand of healthy adults to produce painful and non-painful sensations during unilateral right-hand movements with such an MVF illusion and right and bilateral hand movements without MVF. During these events, electroencephalographic (EEG) activity was recorded from 64 scalp electrodes. Event-related desynchronization (ERD) of EEG alpha rhythms (8-12 Hz) indexed the neurophysiological oscillatory mechanisms inducing cortical activation. Compared to the painful sensations, the non-painful sensations were specifically characterized by (1) lower alpha ERD estimated in the cortical midline, angular gyrus, and lateral parietal regions during the experimental condition with MVF and (2) higher alpha ERD estimated in the lateral prefrontal and parietal regions during the control conditions without MVF. These preliminary results suggest that the MVF-induced movement illusion may affect nociception and neurophysiological oscillatory mechanisms, reducing the activation in cortical limbic and default mode regions.

Effect of Mirror Therapy on Post-Needling Pain Following Deep Dry Needling of Myofascial Trigger Point in Lateral Elbow Pain: Prospective Controlled Pilot Trial.

Background: This prospective randomized, controlled pilot trial to explore the immediate effect of adding Mirror Visual Feedback Therapy on pain sensitivity and motor performance among subjects suffering from post-needling pain diagnosed as Lateral Elbow Pain. Methods: A total of 49 participants (23 female, 26 male) were enrolled and randomly allocated to either the experimental group, which received Deep Dry Needling in the m. Brachioradialis, Ischemic Compression, Cold Spray, Stretching, and Mirror Visual Feedback Therapy (n = 25), or a control group without Mirror Visual Feedback Therapy (n = 24). Pre- and post-treatment evaluations included assessments of post-needling pain intensity, pressure pain threshold, two-point discrimination threshold, and maximum hand grip strength. Results: Intergroup analysis revealed a statistically significant reduction in post-needling pain intensity favoring the experimental group (U = 188.00, p = 0.034). Additionally, intragroup analysis showed significant improvements in post-needling pain intensity (MD = 0.400, SEM = 0.271, W = 137.00, p = 0.047) and pressure pain threshold (MD = 0.148 Kg/cm2, SEM = 0.038, W = 262.00, p < 0.001) within the experimental group following the intervention. Conclusions: These findings suggest a potential benefit of integrating Mirror Visual Feedback Therapy into treatment protocols for individuals with Lateral Elbow Pain experiencing post-needling discomfort. Further research is necessary to fully elucidate the clinical implications of these findings.

Improving motor imagery through a mirror box for BCI users.

The aim of this study was to evaluate mirror visual feedback (MVF) as a training tool for brain-computer interface (BCI) users. This is because approximately 20-30% of subjects require more training to operate a BCI system using motor imagery. Electroencephalograms (EEGs) were recorded from 18 healthy subjects, using event-related desynchronization (ERD) to observe the responses during the movement or movement intention of the hand for the conditions of control, imagination, and the MVF with the mirror box. We constituted two groups: group 1: control, imagination, and MVF; group 2: control, MVF, and imagination. There were significant differences in imagination conditions between groups using MVF before or after imagination (right-hand, P = 0.0403; left-hand, P = 0.00939). The illusion of movement through MVF is not possible in all subjects, but even in those cases, we found an increase in imagination when the subject used the MVF previously. The increase in the r2s of imagination in the right and left hands suggests cross-learning. The increase in motor imagery recorded with EEG after MVF suggests that the mirror box made it easier to imagine movements. Our results provide evidence that the MVF could be used as a training tool to improve motor imagery.NEW & NOTEWORTHY The increase in motor imagery recorded with EEG after MVF (mirror visual feedback) suggests that the mirror box made it easier to imagine movements. Our results demonstrate that MVF could be used as a training tool to improve motor imagery.

The Effect of Transcranial Direct Current Stimulation on M1 with and without Mirror Visual Feedback on Range of Motion and Hand Grip Strength of the Affected Upper Limb in Children with Spastic Hemiplegic Cerebral Palsy.

This study investigated the effects of transcranial direct current stimulation (tDCS) before and during the mirror visual feedback (MVF) on hand grip strength (HGS) and range of motion of the affected hand in children with spastic hemiplegia cerebral palsy (SHCP). Twelve children with SHCP participated in this randomized, crossover, and double-blind study. They were randomly exposed to one of four intervention conditions, including 1) a-tDCS-offline, 2) s-tDCS-offline, 3) a-tDCS-online, and 4) s-tDCS-online, with a one-week interval. Participants in the online condition received either anodal or sham tDCS during MVF, while those in the offline condition received tDCS before performing MVF. The tDCS was applied over the M1 area of the affected hemisphere for 20 minutes at 1 mA intensity. The HGS and range of motion of the wrist and elbow (ROM-W and ROM-E) of the affected limb were measured before (pre) and immediately after (post) interventions in each session. The results showed that the HGS was significantly higher under a-tDCS-offline (p=0.001), s-tDCS-offline (p=0.004), and s-tDCS-online (p=0.005) compared to the a-tDCS-online. Moreover, the ROM-W was significantly higher under a-tDCS-offline (p=0.034), s-tDCS-offline (0.011), and s-tDCS-online (p=0.027) compared to the a-tDCS-online. Eventually, the ROM-E was significantly higher under a-tDCS-offline, s-tDCS-offline, and s-tDCS-online compared to the a-tDCS-online (p ˂0.001; p ˂0.001; p=0.01, respectively). The results might have practical implications regarding the timing of the application of tDCS in conjunction with MVF in children with SHCP.

Comparisons of three different modes of digital mirror therapy for post-stroke rehabilitation: Preliminary results of randomized controlled trial

Objective Technologically adapted mirror therapy shows promising results in improving motor function for stroke survivors. The treatment effects of a newly developed multi-mode stroke rehabilitation system offering multiple training modes in digital mirror therapy remain unknown. This study aimed to examine the effects of unilateral mirror visual feedback (MVF) with unimanual training (UM-UT), unilateral MVF with bimanual training (UM-BT), and bilateral MVF with bimanual training (BM-BT) on clinical outcomes in stroke survivors, compared to classical mirror therapy (CMT). Methods Thirty-five participants were randomly assigned to one of four groups receiving fifteen 60-minute training sessions for 3–4 weeks. The Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Chedoke Arm and Hand Activity Inventory (CAHAI), Revised Nottingham Sensory Assessment (rNSA), Motor Activity Log (MAL), and EQ-5D-5L were administered at pre- and post-intervention and at 1-month follow-up. Results After intervention and follow-up, significant within-group treatment efficacies were found on most primary outcomes of the FMA-UE and CAHAI scores in all four groups. Significant within-group improvements in the secondary outcomes were found on the MAL and EQ-5D-5L index in the UM-BT group, and the rNSA tactile sensation and MAL quality of movement subscales in the BM-BT group. No significant between-group treatment efficacies were found. Conclusions UM-UT, UM-BT, BM-BT, and CMT led to similar clinical effects on the FMA-UE and can be considered effective alternative interventions for post-stroke upper-limb motor rehabilitation. UM-BT and BM-BT showed within-group improvements in functional performance in the patients’ affected upper limbs in real-life activities.

Effectiveness of Mirror Therapy through Telerehabilitation on Upper Extremity Performance in Hemiparetic Stroke Patients: An Experimental Study

Introduction: A major challenge in stroke rehabilitation is the paresis of the Upper Extremity (UE), resulting in limited functional performance. Recently, motor imagery and Mirror Therapy (MT) have been recommended as an additional rehabilitation strategies that could be beneficial for motor rehabilitation after a stroke. Aim: To determine the effectiveness of mirror visual feedback through Telerehabilitation (TR) on UE functional performance in hemiparetic stroke patients. Materials and Methods: An experimental pretest, post-test study design was conducted at SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, Chengalpattu, Tamil Nadu, India from January 2021 to June 2021. Total of 60 patients diagnosed with hemiparetic stroke were included in the study through convenience sampling and divided into two groups. The experimental group (n=30) received TR, and the control group (n=30) received face-to-face MT for 12 weeks. A pretest and post-test evaluation were administered using the Wolf Motor Function Test (WMFT) and Fugl-Meyer Assessment for the Upper Extremity (FMA-UE). Within-group analysis was performed using the Wilcoxon Signed-Rank Test, while intergroup analysis was conducted using the Mann-Whitney U Test. Results: The study revealed statistical significance between the pretest and post-test scores of the WMFT-FAS (Functional Ability Score), WMFT-Time (Performance Time), and FMA-UE in the control and experimental groups. The results showed no statistically significant difference between the post-test scores of the control and experimental groups in the FMA and WMFTFAS. However, there was a statistically significant distinction in the post-test scores between the control and experimental groups in WMFT-Time. Conclusion: The study concluded that mirror visual feedback through TR was an effective treatment method to improve UE functional performance among hemiparetic stroke patients by offering an alternative service delivery model for occupational therapy

Utilization of Mirror Visual Feedback for Upper Limb Function in Poststroke Patients: A Systematic Review and Meta-Analysis.

Mirror visual feedback (MVF), a noninvasive treatment method, is attracting attention as a possibility to promote the recovery of upper limb function in stroke patients. However, the cognitive effects of this therapy have received limited attention in the existing literature. To address this gap, we conducted a systematic review and meta-analysis to investigate the relationship between upper limb function and cognition in stroke patients and to evaluate the effect of MVF on improving upper limb function. A comprehensive search was performed on the Embase, MEDLINE, and PubMed databases to identify original articles and clinical studies published between 2013 and 2022. Qualitative analysis was performed using the Cochrane Risk of Bias tool, and in the quantitative analysis, a random-effects model was used as the effect model, and standard mean difference (SMD) was used as the effect measure. Eight studies that met the inclusion criteria were entered in the analysis. Data extraction included an assessment tool for upper extremity function. Results of the quantitative analysis demonstrate that MVF was effective in improving upper extremity function in stroke patients (SMD = 0.94, 95% CI 0.69 to 1.20). In conclusion, this systematic review and meta-analysis provides evidence supporting the effectiveness of MVF in improving upper limb function in stroke patients. However, further studies are needed to investigate the cognitive effects of MVF and elucidate the underlying mechanisms.

Effect of immersive virtual mirror visual feedback on Mu suppression and coherence in motor and parietal cortex in stroke

We investigated the activation pattern of the motor cortex (M1) and parietal cortex during immersive virtual reality (VR)-based mirror visual feedback (MVF) of the upper limb in 14 patients with chronic stroke and severe upper limb hemiparesis and in 21 healthy controls. Participants performed wrist extension with unaffected wrists (dominant side in controls). In the MVF condition, movement of the affected hand was synchronized with that of the unaffected hand. In the no-MVF condition, only the movement of unaffected hand was shown. Mu suppression in bilateral M1 and parietal cortex and mu coherence were analyzed. In patients with stroke, MVF induced significant mu suppression in both the ipsilesional M1 and parietal lobes (p = 0.006 and p = 0.009, respectively), while mu suppression was observed in the bilateral M1 (p = 0.003 for ipsilesional and p = 0.041 for contralesional M1, respectively) and contralesional parietal lobes in the controls (p = 0.036). The ipsilesional mu coherence between the M1 and parietal cortex in patients with stroke was stronger than controls, regardless of MVF condition (p < 0.001), while mu coherence between interhemispheric M1 cortices was significantly weaker in patients with stroke (p = 0.032). Our findings provide evidence of the neural mechanism of MVF using immersive VR in patients with stroke.

The Effect of Mirror Visual Feedback Therapy on the Hand Mental Rotation in Stroke Patients: An ERP study.

Mirror visual feedback (MVF) intervention is an adjunctive approach for motor recovery after stroke. It has been hypothesized that MVF can increase visual perception, motor imagery, and attention of/to the hands. However, neuroimaging evidence for this hypothesis is still lacking. In this study, we used a hand mental rotation task and event-related potential (ERP) analysis to explore the effect of MVF intervention on visual perception, motor preparation, and motor imagery of hands. We recruited 46 patients and randomly divided them into a mirror visual feedback group (MG) and a conventional intervention group (CG). By comparing ERP amplitude between the two groups and between before and after the intervention, we found that the N200 component, which was considered to be related to motor preparation, was significantly less negative in the affected hemisphere than that in the unaffected counterpart. After intervention, the N200 amplitude became more negative, reflecting a recovery of motor preparation. Specifically, MG showed a significant effect on the N200 for the hand pictures at large orientations, while the CG showed an effect mainly for the upright hand stimuli. The results suggested an improvement of preparation for motor imagery of complex and precise hand movements after MVF intervention.Clinical Relevance- This study might be helpful for understanding the neural mechanisms of MVF which can help stroke patients regain upper extremity function.

Effects of Visual Feedback on Balance and Risk of Fall among Geriatric Population

Introduction: Visual feedback training with a mirror is a technique that can improve postural stability by providing feedback on induced movements via a mirror image of the body image in the mirror. Balance training is considered to be an important aspect of a fall prevention program. Damage to balance ability causes difficulty in walking and performing functional activities. Hence, balance ability is the basis for independent movement and functional performance the aim is to find out the effects of visual feedback on balance and risk of fall among geriatric population. Aim and objectives: The aim and objective of the study is to find the effects of visual feedback on balance and risk of fall among geriatric population. Methodology: This study is an experimental study. A total of 30 geriatric population were selected based upon the inclusion and exclusion criteria. The participants were separated into two groups, the conventional group and the experimental group, each with 15 members. The detailed procedure was explained to the participants and a written informed consent form was obtained. Result: The values were statistically analyzed. The post-test mean value of Berg Balance scale in experimental group was 45.9 and conventional group was 43.2. This showed that Berg Balance Scale in experimental group was comparatively higher than conventional group. The post mean value of fall efficacy scale in experimental group was 4.80 and in conventional group was 5.93. This proves that fall efficacy scale in experimental group was comparatively less than conventional group. Conclusion: This study concluded that mirror visual feedback of experimental group was found more effective than conventional therapy in reducing risk of fall and increasing balance.

Mirror Visual Feedback as a Therapeutic Modality in Complex Regional Pain Syndrome type I - A Randomized Controlled Trial (P9-6.001)

<h3>Objective:</h3> To evaluate the efficacy of Mirror visual feedback as a therapeutic modality in the treatment of complex regional pain syndrome type I. <h3>Background:</h3> Complex regional pain syndrome (CRPS) type I is a clinical syndrome of variable course and unknown etiology characterized by neuropathic pain, vasomotor dysfunction of an extremity and autonomic abnormality. This condition is often the result of trauma, surgery or stroke. Its pathogenesis typically involves an exaggerated inflammatory response following injury to the extremities. There is growing evidence for the effectiveness of Mirror Therapy (MT) on pain reduction in patients with CRPS I. This mode of therapy has also the potential to reduce reliance on opioids to control pain and reduce healthcare costs. <h3>Design/Methods:</h3> Randomized Control Trial. The intervention group, (n13, patients undergoing MT), every day for 10 minutes were compared to the control group, (n14, not receiving MT). A crossover model was used at the end of each 6 weeks intervention period. <h3>Results:</h3> Patients with CRPS I undergoing MT were compared to patients not receiving MT demonstrated improvement in treatment parameters after a period of 6 weeks of intervention. Treatment parameters included: Active range of motion, dexterity, muscle strength, edema and Health-Related Quality of life. The retrograde spread of peripheral lesions to CNS may play a role in development of chronic pain (Ramachandran, 2012). Functional cortical reorganizations, have been shown to be present in subjects with CRPS I by positron emission tomography (PET) scan (Juottonen et al., 2002). A distorted representation of the limb in the cortex has been proposed as causing discrepancies between motor intention, proprioception, and vision. This distortion can be perceived as pain. <h3>Conclusions:</h3> Principles focused on neural feedback to the central nervous system, including Mirror Therapy is a cost effective treatment for pain reduction in CRPS I patients with potentials in reducing the burden of opioid use. <b>Disclosure:</b> Dr. Machac has received research support from Grant Agency of Charles University . Dr. Kakawand has nothing to disclose. Mrs. Chasakova has nothing to disclose. Lubomir Stepanek has nothing to disclose. Dr. Vejvalka has nothing to disclose. Dr. Cerny has nothing to disclose.

Force/moment tracking performance during constant-pose, force-varying, bilaterally symmetric, hand-wrist tasks.

Bilateral movement is widely used for calibration of myoelectric prosthesis controllers, and is also relevant as rehabilitation therapy for patients with motor impairment and for athletic training. Target tracking and/or force matching tasks can be used to elicit such bilateral movement. Limited descriptive accuracy data exist in able-bodied subjects for bilateral target tracking or dominant vs non-dominant dynamic force matching tasks requiring more than one degree of freedom (DoF). We examined dynamic trajectory (0.75Hz band-limited, white, uniform random) constant-posture, hand open-close, wrist pronation-supination target tracking and matching tasks. Tasks were normalized to maximum voluntary contraction (MVC), spanning a±30% MVC force range, in four 1-DoF and 2-DoF tasks: (1, 2) unilateral dominant limb tracking with/without visual feedback, and (3, 4) bilateral dominant/non-dominant limb tracking with mirror visual feedback. In 12 able-bodied subjects, unilateral tracking error with visual feedback averaged 10-15%MVC, but up to 30%MVC without visual feedback. Bilateral matching error averaged∼10%MVC and was affected little by visual feedback type, so long as feedback was provided. In 1-DoF bilateral tracking, the dominant side had statistically lower error than the non-dominant side. In 2-DoF bilateral tracking, the side providing mirror visual feedback exhibited lower error than the opposite side. In 2-DoF tasks (assumed to be more challenging than their constituent 1-DoF tracking tasks), hand grip force errors grew disproportionately larger than those of each wrist DoF. In unilateral 1-DoF tasks, both hand vs target and wrist vs target latency averaged 250-350ms. In unilateral 2-DoF tasks, wrist vs target latency also averaged 250-350ms, while hand vs target latency averaged>500ms. These results provide guidance on bilateral 2-DoF hand-wrist performance in target tracking, and dominant vs non-dominant force matching tasks.

The instant effect of embodiment via mirror visual feedback on electroencephalogram-based brain connectivity changes: A pilot study.

The therapeutic efficacy of mirror visual feedback (MVF) is attributed to the perception of embodiment. This study intends to investigate the instantaneous effect of embodiment on brain connectivity. Twelve healthy subjects were required to clench and open their non-dominant hands and keep the dominant hands still during two experimental sessions. In the first session, the dominant hand was covered and no MVF was applied, named the sham-MVF condition. Random vibrotactile stimulations were applied to the non-dominant hand with MVF in the subsequent session. Subjects were asked to pedal while having embodiment perception during motor tasks. As suggested by previous findings, trials of no vibration and continuous vibration were selected for this study, named the condition of MVF and vt-MVF. EEG signals were recorded and the alterations in brain connectivity were analyzed. The average node degrees of sham-MVF, MVF, and vt-MVF conditions were largely different in the alpha band (9.94, 11.19, and 17.37, respectively). Further analyses showed the MVF and vt-MVF had more nodes with a significantly large degree, which mainly occurred in the central and the visual stream involved regions. Results of network metrics showed a significant increment of local and global efficiency, and a reduction of characteristic path length for the vt-MVF condition in the alpha and beta bands compared to sham-MVF, and in the alpha band compared to MVF. Similar trends were found for MVF condition in the beta band compared to sham-MVF. Moreover, significant leftward asymmetry of global efficiency and rightward asymmetry of characteristic path length was reported in the vt-MVF condition in the beta band. These results indicated a positive impact of embodiment on network connectivity and neural communication efficiency, which reflected the potential mechanisms of MVF for new insight into neural modulation.

Cortical sources of electroencephalographic alpha rhythms related to the anticipation and experience of mirror visual feedback-induced illusion of finger movements.

Mirror visual feedback (MVF) technique consists in placing a mirror in a person's body midline to induce the illusion of bilateral synchronous movements of the limbs during actual unilateral movements. A recent electroencephalographical (EEG) study demonstrated that MVF-induced illusion was related to the event-related desynchronization (ERD) of alpha (8-12 Hz) rhythms (cortical activation) at the central and parietal scalp electrodes ipsilateral to the unilateral right finger movements. In the present study, we re-analyzed those data to localize the cortical sources of alpha ERD during the anticipation and experience of the MVF-induced illusion of index finger movements. To this aim, the exact Low-Resolution Brain Electromagnetic Tomography freeware was used for the estimation of the cortical sources of the alpha ERD. Results showed that as compared to the condition without MVF, the MVF condition was characterized by greater (p< .01, uncorrected) alpha ERD sources in right frontopolar areas during the anticipation of the MVF-induced illusion of left movements. The MVF condition was also characterized by greater (p< .05, corrected) alpha ERD sources in right premotor, primary somatomotor, and posterior inferior parietal areas during both the anticipation and experience of that MVF-induced illusion. These findings suggest that the MVF-induced illusory experience of left finger movements may be due to dynamic changes in alpha ERD in associative, premotor, somatomotor, and visuomotor frontal-parietal areas located in the hemisphere contralateral to the mirrored motor acts.

Effects of Unilateral Neuromuscular Electrical Stimulation with Illusionary Mirror Visual Feedback on the Contralateral Muscle: A Pilot Study.

We aim to examine the cross-education effects of unilateral muscle neuromuscular electrical stimulation (NMES) training combined with illusionary mirror visual feedback (MVF). Fifteen adults (NMES + MVF: 5; NMES: 5, Control: 5) completed this study. The experimental groups completed a 3-week NMES training on their dominant elbow flexor muscle. The NMES + MVF group had a mirror placed in the midsagittal plane between their upper arms, so a visual illusion was created in which their non-dominant arms appeared to be stimulated. Baseline and post-training measurements included both arms' isometric strength, voluntary activation level, and resting twitch. Cross-education effects were not observed from all dependent variables. For the unilateral muscle, both experimental groups showed greater strength increases when compared to the control (isometric strength % changes: NMES + MVF vs. NMES vs. Control = 6.31 ± 4.56% vs. 4.72 ± 8.97% vs. -4.04 ± 3.85%, p < 0.05). Throughout the training, even with the maximally tolerated NMES, the NMES + MVF group had greater perceived exertion and discomfort than the NMES. Additionally, the NMES-evoked force increased throughout the training for both groups. Our data does not support that NMES combined with or without MVF induces cross-education. However, the stimulated muscle becomes more responsive to the NMES and can become stronger following the training.

The Effect of Mirror Visual Feedback on Spatial Neglect for Patients after Stroke: A Preliminary Randomized Controlled Trial.

We investigated the effects of mirror visual feedback (MVF), with reference to using a glass wall or a covered mirror, on the reduction of spatial neglect for patients with stroke. A total of 21 subacute patients with left spatial neglect after right-hemispheric stroke were randomly assigned to 3 groups: MVF, sham 1 (viewing the hemiparetic arm through the transparent glass during bilateral arm movement) and sham 2 (using a covered mirror). The 3-week treatment program for all groups consisted of 12 sessions of movement tasks for the hemiparetic arm graded according to the severity of arm impairments. Blinded assessments were administered at pre/post and a three-week follow-up. The results showed that there was no significant advantage for MVF than sham 1; however, MVF was more beneficial than sham 2, as shown by the line crossing (p = 0.022). Improvement in discriminating the left-gap figures on the left and right side of the page in the Gap Detection Test was greater in MVF than using the covered mirror (p = 0.013; p = 0.010), showing a slight advantage of MVF in alleviating allocentric symptoms. Our study confirms that MVF was superior to using a covered mirror as a method for reducing spatial neglect and in alleviating its allocentric symptoms, but no significant advantage over bilateral arm movement through transparent glass was found. Further research in comparing their therapeutic effects is warranted.

Re-evaluation of Mirror Visual Feedback Therapy for a Systematic Evaluation/Meta-analysis of Physical Function Re-education After Stroke.

The aim of the study is to re-evaluate the methodological quality and quality of evidence for a systematic evaluation/meta-analysis of the effect of mirror visual feedback therapy on physical function re-education after stroke. Systematic evaluations/meta-analyses of mirror visual feedback therapy on physical function re-education after stroke were searched in the China Knowledge Network database, Wanfang database, Vipers database, China Biomedical Literature database, PubMed, Web of Science, and Embase using a computer, and the search time frame was up to January 2022. Methodological quality and quality of evidence ratings of the included studies were determined using the AMSTAR2 scale and GRADE classification by two authors. Seventeen publications were included. The evaluation with the AMSTAR2 scale showed that one study had an intermediate quality rating, five had a low-quality rating, and the remaining 11 were all very low quality. The GRADE scale showed 93 outcome indicators, of which 6 were intermediate, 23 were low grades, and the rest were very low grades, with low overall quality. Mirror visual feedback therapy is efficacious for physical function re-education after stroke and promotes recovery from physical dysfunction, but the methodological quality and quality of evidence from the related systematic evaluations/meta-analyses are low.

FEATURES OF MIRROR VISUAL FEEDBACK APPLICATION FOR PATIENTS WITH PHANTOM LIMB PAIN IN THE PRESENCE OF ATYPICAL PHANTOM POSITION

One of the most interesting methods of neurorehabilitation is Mirror Visual Feedback (MVF). Despite the widespread information about effectiveness of MVF, specialists who have previously used this method but have not achieved positive results when working with patients, have many questions about the specific features of its application. Objective. The aim of our study was evaluation of the MVF effectiveness for reducing the severity of phantom pain in an amputated limb in the presence of atypical phantom location. Material and Methods: The study involved 29 patients with phantom limb pain. The severity of pain and quality of life were assessed. Results: It was found that the effectiveness of the MVF depends on some important factors, such as a discrepancy between the location of the phantom at the level of sensations and in reflection, duration and severity of the pain syndrome. Conclusions. An important factor in the successful results of the MVF application is assessment of the initial position of the phantom and ability to change its position in space at the sensory level. A decrease in the severity of phantom pain can create in the long-term the illusion that the patient has adapted to the problem. The timing and frequency of the MVF course should be selected individually, depending on the duration, severity of phantom pain and patient fatigue. It is assumed that the use of MVF in the early period after amputation prevents the development of phantom pain, which requires further research in this direction.

Mirror visual feedback during unilateral finger movements is related to the desynchronization of cortical electroencephalographic somatomotor alpha rhythms.

Using a mirror adequately oriented, the motion of just one hand induces the illusion of the movement with the other hand. Here, we tested the hypothesis that such a mirror phenomenon may be underpinned by an electroencephalographic (EEG) event-related desynchronization/synchronization (ERD/ERS) of central alpha rhythms (around 10Hz) as a neurophysiological measure of the interactions among cerebral cortex, basal ganglia, and thalamus during movement preparation and execution. Eighteen healthy right-handed male participants performed standard auditory-triggered unilateral (right) or bilateral finger movements in the No Mirror (M-) conditions. In the Mirror (M+) condition, the unilateral right finger movements were performed in front of a mirror oriented to induce the illusion of simultaneous left finger movements. EEG activity was recorded from 64 scalp electrodes, and the artifact-free event-related EEG epochs were used to compute alpha ERD. In the M- conditions, a bilateral prominent central alpha ERD was observed during the bilateral movements, while left central alpha ERD and right alpha ERS were seen during unilateral right movements. In contrast, the M+ condition showed significant bilateral and widespread alpha ERD during the unilateral right movements. These results suggest that the above illusion of the left movements may be related to alpha ERD measures reflecting excitatory desynchronizing signals in right lateral premotor and primary somatomotor areas possibly in relation to basal ganglia-thalamic loops.