Dohle Christian, Püllen Judith, Nakaten Antje, Küst Jutta, Rietz Christian, Karbe Hans
Klinik Berlin, Department of Neurological Rehabilitation, Charite-University Medicine Berlin, Campus Benjamin Franklin, Germany.
Neurorehabil Neural Repair. 2009 Mar-Apr;23(3):209-17. doi: 10.1177/1545968308324786. Epub 2008 Dec 12.
. Rehabilitation of the severely affected paretic arm after stroke represents a major challenge, especially in the presence of sensory impairment.
. To evaluate the effect of a therapy that includes use of a mirror to simulate the affected upper extremity with the unaffected upper extremity early after stroke.
. Thirty-six patients with severe hemiparesis because of a first-ever ischemic stroke in the territory of the middle cerebral artery were enrolled, no more than 8 weeks after the stroke. They completed a protocol of 6 weeks of additional therapy (30 minutes a day, 5 days a week), with random assignment to either mirror therapy (MT) or an equivalent control therapy (CT). The
were the Fugl-Meyer subscores for the upper extremity, evaluated by independent raters through videotape. Patients also underwent functional and neuropsychological testing.
. In the subgroup of 25 patients with distal plegia at the beginning of the therapy, MT patients regained more distal function than CT patients. Furthermore, across all patients, MT improved recovery of surface sensibility. Neither of these effects depended on the side of the lesioned hemisphere. MT stimulated recovery from hemineglect.
. MT early after stroke is a promising method to improve sensory and attentional deficits and to support motor recovery in a distal plegic limb.
中风后严重瘫痪手臂的康复是一项重大挑战，尤其是在存在感觉障碍的情况下。
评估一种在中风后早期使用镜子将患侧上肢与健侧上肢进行模拟的治疗方法的效果。
纳入36例首次发生大脑中动脉供血区缺血性中风且偏瘫严重的患者，中风后不超过8周。他们完成了一个为期6周的额外治疗方案（每天30分钟，每周5天），随机分为镜像疗法（MT）组或等效对照疗法（CT）组。
由独立评估者通过录像对上肢的Fugl-Meyer子评分进行评估。患者还接受了功能和神经心理学测试。
在治疗开始时25例远端瘫痪患者的亚组中，MT组患者比CT组患者恢复了更多的远端功能。此外，在所有患者中，MT改善了表面感觉的恢复。这些效果均不依赖于受损半球的侧别。MT促进了偏侧空间忽视的恢复。
中风后早期的MT是一种有前景的方法，可改善感觉和注意力缺陷，并支持远端瘫痪肢体的运动恢复。
