Mirror therapy for patients with severe arm paresis after stroke – a randomized controlled trial

• Published in: Clinical rehabilitation Vol. 27; no. 4; pp. 314 - 324
• Main Authors: Thieme, Holm, Bayn, Maria, Wurg, Marco, Zange, Christian, Pohl, Marcus, Behrens, Johann
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2013; Sage Publications Ltd
• Subjects: Action research; Activities of Daily Living; Activity level; Aged; Agnosia - etiology; Agnosia - rehabilitation; Analysis of Variance; Arm - physiopathology; Barthel Index; Clinical trials; Female; Group therapy; Humans; Individual therapy; Inpatient care; Intervention; Interventions; Male; Motor ability; Motor Skills - physiology; Occupational therapy; Paresis; Paresis - etiology; Paresis - physiopathology; Paresis - rehabilitation; Physical therapy; Physical Therapy Modalities - instrumentation; Quality of Life; Recovery of Function; Rehabilitation; Rehabilitation Centers; Severity; Sickness Impact Profile; Stroke; Stroke - complications; Stroke - physiopathology; Stroke Rehabilitation; Strokes; Tests; Bavaria Germany; Germany; visuospatial neglect; Stroke; motor function; upper extremity; mirror therapy
• ISSN: 0269-2155; 1477-0873; 1477-0873
• DOI: 10.1177/0269215512455651

Objective: To evaluate the effects of individual or group mirror therapy on sensorimotor function, activities of daily living, quality of life and visuospatial neglect in patients with a severe arm paresis after stroke. Design: Randomized controlled trial. Setting: Inpatient rehabilitation centre. Subject: Sixty patients with a severe paresis of the arm within three months after stroke. Interventions: Three groups: (1) individual mirror therapy, (2) group mirror therapy and (3) control intervention with restricted view on the affected arm. Main measures: Motor function on impairment (Fugl-Meyer Test) and activity level (Action Research Arm Test), independence in activities of daily living (Barthel Index), quality of life (Stroke Impact Scale) and visuospatial neglect (Star Cancellation Test). Results: After five weeks, no significant group differences for motor function were found (P > 0.05). Pre–post differences for the Action Research Arm Test and Fugl-Meyer Test: individual mirror therapy: 3.4 (7.1) and 3.2 (3.8), group mirror therapy: 1.1 (3.1) and 5.1 (10.0) and control therapy: 2.8 (6.7) and 5.2 (8.7). However, a significant effect on visuospatial neglect for patients in the individual mirror therapy compared to control group could be shown (P < 0.01). Furthermore, it was possible to integrate a mirror therapy group intervention for severely affected patients after stroke. Conclusion: This study showed no effect on sensorimotor function of the arm, activities of daily living and quality of life of mirror therapy compared to a control intervention after stroke. However, a positive effect on visuospatial neglect was indicated.