Various techniques, such as scanning, visual cueing approaches, limb activation strategies, visual imagery, prisms, and sustained attention training, are being used to treat unilateral neglect. Therapy vibration therapy ultrasound analgesics psychological interventions sensory overload mirror therapy treatment for phantom pain. Sep 09, 2014 various techniques, such as scanning, visual cueing approaches, limb activation strategies, visual imagery, prisms, and sustained attention training, are being used to treat unilateral neglect. Although initially developed for amputees to control phantom limb pain, it is now commonly used for many different conditions. Jax discusses his latest research to determine whether mirror therapy in the home setting is an effective method of therapy for stoke patients after they have completed their. Mirror therapy works by essentially tricking the brain out of pain. Mirror box therapy exercises for stroke recovery saebo. Hand questionnaire as a measure of manual ability in chronic stroke. Because pain signals are processed in the brain, we can change the brain input and get different output in terms of pain. It can also be given by a family caregiver or be selfadministered following a brief explanation of how to do it and after receiving tools to do the therapy at home user guide, written explanations, photos or videos of the movements to be done. Effectiveness of mirror therapy on function for chronic.
The mirror group received an additional 30 minutes for the first 2 weeks and 1 hour for the last 2 weeks per session of a mirror therapy program consisting of unaffected upper limb movements. Mirror therapy was also shown to be superior to placebo and mental visualization comparison groups. In a study that compared mirror therapy as an addition to conventional therapeutic techniques for rehabilitation of the hand following stroke, mohanty, et. The technique utilizes the mirrorillusion created by the movement of sound limb that is perceived as the paretic limb. Evaluation of mirror therapy for upper limb rehabilitation. Pdf the clinical aspects of mirror therapy in rehabilitation. There is also the potential that bilateral exercise as a train. Evaluation of mirror therapy for upper limb rehabilitation in. Study group was given mirror therapy in addition to the conventional stroke rehabilitation programme. Mirror therapy is often given by occupational therapists and physiotherapists but any health professional can administer it.
Mirror therapy mt is a rehabilitation approach that uses a mirror placed aside the patients trunk, hiding the paretic upper limb and reflecting the contralateral healthy arm. Effects and adherence of mirror therapy in people with. Amputee rehabilitation lynn cunningham, pt, dpt helena lax, md mark nielsen, cp, atc. To compare the effects of mirror therapy mt versus control treatment ct on movement. The type of supporting evidence is identified and graded for each recommendation see the major recommendations field. Rehabilitation strategies are required to be repetitive, intensive, and taskspecific for neuroplasticity to produce recovery. Mirror therapy in unilateral neglect after stroke must trial. The wider use of mirrors in this way is known as mirror therapy or mirror visual feedback mvf. Graded motor imagery to improve clinical outcomes 2192015 combined. The methodology and the mechanism by which mirror therapy works have been discussed.
Mirror therapy mt uses visual feedback while focusing on the movement of contralateral limbs. Using movements of the stronger body part to trick our brain into thinking that the weaker body part is moving. A withinsubject, repeatedmeasures study with 12 people with chronic hemiparesis was conducted. In mirror therapy, we use movements of the stronger hand and arm to trick our brain into thinking that the weaker arm is moving. To understand how this process works, youll need to know about mirror neurons and neuroplasticity. Mirror therapy is especially useful for people who have very little movement of their arm and hand after a stroke. Wadee,h the objective of this study was to evaluate the clinical. The clinical aspects of mirror therapy in rehabilitation. Feb 07, 2020 rehabilitation strategies are required to be repetitive, intensive, and taskspecific for neuroplasticity to produce recovery.
In this way, moving one half of the body and looking into the mirror, it is possible to have the illusion that gestures are carried out by the. Mar 06, 2020 mirror therapy offers an interesting method for regaining mobility after a stroke even if the hand and arm are paralyzed. The theory behind mirror therapy is that positive visual feedback will encourage neuroplastic change, leading to a more swift recovery for survivors. Patients and methods patients from october 2000 to december 2006, a total of 208 patients 81 women and 127 men, mean age 62. Mirror therapy in the rehabilitation of lowerlimb amputatio. Pdf evaluation of mirror therapy for upper limb rehabilitation in. It allows patients to view a reflection of their anatomical limb in the visual space occupied by their phantom limb.
Mirror therapy box rehab kit suitable for stroke rehabilitation, phantom limb pain, complex regional pain syndrome crps, arthritis, neuropathic and chronic pain rehabilitation. Electronic databases, including the cochrane library, pubmed, medline, embase and cnksystematic, were searched for relevant studies published in english between 1 january 2007 and 22 june 2017. Below you will learn how to do mirror therapy in 3 steps, along with some useful mirror therapy exercise guides. Pdf the objective of this study was to evaluate the clinical aspects of mirror therapy mt interventions after stroke, phantom limb pain and. A randomized controlled trial christian dohle, md, mphil, judith pullen, antje nakaten, jutta kust, phd, christian rietz, phd, and hans karbe, md background. We do know that after the occurrence of stroke most reco very takes place within the first six to twelve. Rehabilitation of the severely affected paretic arm after stroke represents a major challenge, especially in the presence of. Mirror box therapy and its development immersive virtual reality is used in pain therapy and in rehabilitation of people with amputation affected by phantom limbrelated phenomena. Mirror therapy offers an interesting method for regaining mobility after a stroke even if the hand and arm are paralyzed. However, the optimal starting point of mirror the rapy after stroke is unclear. Large mirror size mirror size of 14 x 10 inch suitable for upper limbs. The aim of this study is to find the effect of mirror therapy in rehabilitation of hand function in subacute stroke. Archives of physical medicine and rehabilitation 20.
Most research to date supports mt in conjunction with traditional stroke rehabilitation producing positive effects on ue function, including improvements in motor recovery and performance of the affected ue when provided within 2 to 12 mo poststroke at a high intensity. Mt involves the superimposition of reflections of unaffected limb movements on the. Occupational therapy practice guidelines for adults with stroke. It can also help increase movement in a limb, for example, following a stroke. To note, mirror therapy is a simple and inexpensive treatment that patients can practice independently and with no significant side effects. Many concepts in multiple sclerosis ms rehabilitation come from stroke and pain rehabilitation fields. Mirror therapy in complex regional pain syndrome type 1 of. Portable and easy storage compact, lightweight and portable. The mirror therapy can bring positive changes for motor recovery of upper extremity, the mirror therapy program in this study is effective for functional recovery of upper extremity after stroke. We hope that this protocol facilitates the tailored treatment of patients after stroke with mirror therapy in everyday care. Nearly 800,000 people suffer strokes in the united states annually, and more than 80 percent of these individuals experience a motor deficit as a result.
A total of 30 subjects with hemiplegia due to stroke were randomly selected and were recruited from physiotherapy. This was first described in 1995 by ramachandran and his team who studied phantom limb pain. Reflections on mirror therapy in stroke repub, erasmus university. Does mirror therapy and a traditional rehabilitation program. There is some encouraging evidence that suggests that by using mirror therapy, the part of your brain that is damaged is stimulated, encouraging recovery. In a mirror box the patient places the good limb into one. Akyuz, g, kenis, o 20 physical therapy modalities and rehabilitation techniques in the treatment of neuropathic pain int j phys med rehabil 1. Mirror therapy for stroke rehab helps improve severe arm and hand impairments. In contrast to varied therapy approaches, mirror therapy mt can be used even in completely plegic stroke survivors, as it uses visual stimuli for producing a desired response in the affected limb.
The effect of mirror therapy on functional recovery of upper. The effect of mirror therapy on functional recovery of. Guide to mirror therapy and the benefits of neuroplasticity. To evaluate the mean treatment effect of mirror therapy on motor function of the upper extremity in patients with stroke. Mirror therapy efficacy in upper limb rehabilitation early. A mirror box can be purchased, or made for those with a preference for diy. Many researches have been conducted so far in acute, subacute or chronic stage but it is still unclear as to which one is benefitted the most. There is some evidence that improved recovery can result from more therapy 25, earlier therapy 2629, and therapies that incorporate highly repetitive movement training 30. Mirror therapy promotes recovery from severe hemiparesis.
A 2016 study supports the use of mirror therapy to encourage motor recovery in poststroke hemiparesis. Reduced motor function negatively impacts independence and overall quality of life for millions of survivors around the globe. Mirror therapy for improving motor function after stroke. The research on how well this intervention works is still quite new. Evaluation of mirror therapy for upper limb rehabilitation in stroke.
On this basis, it was first used to aid in the recovery of upper limb ul hemiparesis following stroke a decade ago altschuler et al. The effectiveness of mirror therapy with stroke patients in. This paper discusses about one of the upcoming therapies i. Effectiveness of mirror therapy in rehabilitation of hand. Mirror therapy for improving motor function after stroke stroke. Mirror therapy should therefore be considered as one of several therapy interventions within a rehabilitation programme where other interventions can be offered as well, or sometimes may even be. Occupational therapy practice guidelines for adults with. Effects of action observation therapy and mirror therapy. A total of 30 subjects with hemiplegia due to stroke were. A mirror box is a box with a mirror down the center facing toward a patients intact limb, invented by vilayanur s. If you put your left hand behind a mirror and right hand in front, you can trick your brain into believing that the reflection of your right hand in the mirror is your left. In recent years mirror therapy has been used in stroke rehabilitation, both to ease motor e.
However, there has been little investigation on the effect on upper limb sensory impairments, activity limitations, and participation restrictions. The effects of mirror therapy on pain and motor control of. Effects of action observation therapy and mirror therapy after stroke on rehabilitation outcomes and neural mechanisms by meg. In mirror therapy, a patient performs exercises with an unaffected limb but because of the reflective surfaces inside the box, it appears as though the affected limb is being exercised.
Mirror therapy is a promising therapy with some benefit for motor recovery in people with chronic hemiparesis. Because mirror therapy is designed to treat motor impairment, its important to remember that this treatment is rooted in the basic principles of motor learning. Wadee,h the objective of this study was to evaluate the clinical aspects of mirror therapy mt interventions after stroke. Methodology study design two group, pretest posttest structured, experimental study design.
The effects of mirror therapy on pain and motor control of phantom limb in amputees. Mirror therapy mt is a valuable method for enhancing motor recovery in poststroke hemiparesis. Mt is a simple and economical technique than can stimulate the brain noninvasively. Mirror therapy, stroke, mirror neuron, upper extremity. Mirror therapy rehabilitation has helped many people control their pain independently and in their home environment. Mirror therapy was studied in the time shortly after stroke and up to 6 months later, for both arm and leg rehabilitation. At the end, well share a success story of how mirror therapy helps stroke patients with arm and hand paralysis recovery.
Effectiveness of mirror therapy in upper limb rehabilitation. It was delivered in hospitals, as part of inpatient and outpatient rehabilitation, and at home. Then, at the end of this article, well show you how to do mirror how mirror therapy helps improve movement after stroke even with. Mirror therapy is a specific therapy designed to strengthen arms and hands weakened by a stroke. Because pain signals are processed in the brain, we can change the brain input and get different output in. Principle of mirror therapy in mirror therapy, a mirror is placed beside the unaffected limb, blocking the view of the affected limb. Treatment effects improving motor function reducing pain reducing neglect reducing sensory impairment. Ramachandran to help alleviate phantom limb pain, in which patients feel they still have a limb after having it amputated. Compared to a traditional rehabilitation program and an. Effects of mirror therapy on motor and sensory recovery in chronic. Therapist protocol for parkinson disease history focus on history of freezing episodes, tremors, bradykinesia, rigidity, falls during medication on or off times, dropping items, fine and gross motor coordination, difficulty swallowingtalking loud memory, hep, time schedule for meds.