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|The efficacy of lower extremity mirror therapy for improving balance, gait, and motor function poststroke: a systematic review and meta-analysis|
|Louie DR, Lim SB, Eng JJ|
|Journal of Stroke & Cerebrovascular Diseases 2019 Jan;28(1):107-120|
BACKGROUND: Mirror therapy is less commonly used to target the lower extremity after stroke to improve outcomes but is simple to perform. This review and meta-analysis aimed to evaluate the efficacy of lower extremity mirror therapy in improving balance, gait, and motor function for individuals with stroke. METHODS: PubMed, Cochrane Central Register of Controlled Trials, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and PsycINFO were searched from inception to May 2018 for randomized controlled trials (RCTs) comparing lower extremity mirror therapy to a control intervention for people with stroke. Pooled effects were determined by separate meta-analyses of gait speed, mobility, balance, and motor recovery. RESULTS: Seventeen RCTs involving 633 participants were included. Thirteen studies reported a significant between-group difference favoring mirror therapy in at least one lower extremity outcome. In a meta-analysis of 6 trials that reported change in gait speed, a large beneficial effect was observed following mirror therapy training (standardized mean differences (SMD) 1.04 (95% confidence interval (CI) 0.43 to 1.66), I2 = 73%, and p < 0.001). Lower extremity mirror therapy also had a positive effect on mobility (5 studies SMD 0.46 (95% CI 0.01 to 0.90), I2 = 43%, and p = 0.05) and motor recovery (7 studies SMD 0.47 (95% CI 0.21 to 0.74), I2 = 0%, and p < 0.001). A significant pooled effect was not found for balance capacity. CONCLUSIONS: Mirror therapy for the lower extremity has a large effect for gait speed improvement. This review also found a small positive effect of mirror therapy for mobility and lower extremity motor recovery after stroke.