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Effects of mirror therapy on motor and sensory recovery in chronic stroke: a randomized controlled trial
Wu C-Y, Huang P-C, Chen Y-T, Lin K-C, Yang H-W
Archives of Physical Medicine and Rehabilitation 2013 Jun;94(6):1023-1030
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To compare the effects of mirror therapy (MT) versus control treatment (CT) on movement performance, motor control, sensory recovery, and performance of activities of daily living in people with chronic stroke. DESIGN: Single-blinded, randomized controlled trial. SETTING: Four hospitals. PARTICIPANTS: Thirty-three outpatients with chronic stroke, with mild to moderate motor impairment. INTERVENTIONS: The MT group (n = 16) received upper extremity training involving repetitive bimanual, symmetrical movement practice in which the individual moves the affected limb while watching the reflective illusion of the unaffected limb's movements from a mirror. The CT group received task-oriented upper extremity training. The intensity for both groups was 1.5 hours/day, 5 days/week, for 4 weeks. MAIN OUTCOME MEASUREMENTS: The Fugl-Meyer Assessment (FMA); kinematic variables, including reaction time, normalized movement time, normalized total displacement, joint recruitment, and maximum shoulder-elbow cross-correlation; the Revised Nottingham Sensory Assessment (rNSA), the Motor Activity Log (MAL), and the ABILHAND Questionnaire. RESULTS: The MT group performed better in the overall (p = 0.01) and distal part (p = 0.04) FMA scores and demonstrated shorter reaction time (p = 0.04), shorter normalized total displacement (p = 0.04), and greater maximum shoulder-elbow cross-correlation (p = 0.03). The rNSA temperature scores improved significantly more in the MT group than in the CT group. No significant differences on the MAL and ABILHAND were found immediately after MT or at follow-up. CONCLUSIONS: The application of MT after stroke might result in beneficial effects on movement performance, motor control, and temperature sense but may not translate into daily functions in the chronic stroke population.

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