Pt. Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice & Empowerment, Government of India, New Delhi, India.
Top Stroke Rehabil. 2013 May-Jun;20(3):210-7. doi: 10.1310/tsr2003-210.
Mirror therapy (MT) is an alternative therapeutic intervention that uses the interaction of visuomotor-proprioception inputs to enhance movement performance of the impaired limb. Despite strong evidence for task-specific training in stroke, MT has been investigated using nontask movements. The aim of this pilot study was to assess the effectiveness of task-based MT on motor recovery of the upper extremity in chronic stroke patients.
In a pretest-posttest single-group design, a convenience sample of 13 chronic stroke patients at an occupational therapy department of a rehabilitation institute was assessed on a task-based MT intervention. Participants received a task-based MT program, performing various tasks by the less affected upper extremity and observing in the mirror box along with conventional management, 4 days per week for 4 weeks. Fugl-Meyer Assessment (FMA), which includes subsection upper extremity (FMA-UE) and subpart upper arm (FMA-UA) and hand (FMA-WH), was used as an outcome measure.
Participants showed no significant improvement for FMA-UE and FMA-UA at postassessment. FMA-UE changed from 43% to 51%. Post FMA-UA score showed only 2% improvement. However, there was statistically significant improvement on mean scores of FMA-WH at postassessment (16.21 ± 3.06) as compared with the prescores (12.29 ± 3.1; P < .05). FMA-WH improved from 41% to 54%.
The preliminary findings suggest that task-based MT is effective in improving wrist and hand motor recovery in chronic stroke patients. Further studies in the form of randomized trials are needed to validate its effectiveness.
镜像疗法(MT)是一种替代治疗干预措施,利用视动本体感觉输入的相互作用来增强受损肢体的运动表现。尽管有强烈的证据表明运动任务特异性训练在中风中有效,但 MT 已经被用于非任务运动的研究。本研究旨在评估基于任务的 MT 对慢性中风患者上肢运动功能恢复的有效性。
采用预测试-后测试单组设计,对康复研究所职业治疗部门的 13 例慢性中风患者进行基于任务的 MT 干预评估。参与者接受基于任务的 MT 计划,通过非患侧上肢执行各种任务,并在镜子盒子里观察,同时进行常规管理,每周 4 天,持续 4 周。采用 Fugl-Meyer 评估(FMA),包括上肢部分(FMA-UE)和上臂部分(FMA-UA)和手部分(FMA-WH),作为评估结果。
参与者在后期评估中 FMA-UE 和 FMA-UA 没有显著改善。FMA-UE 从 43%增加到 51%。FMA-UA 的后期评分仅提高了 2%。然而,后期 FMA-WH 的平均评分(16.21±3.06)与前期评分(12.29±3.1;P<.05)相比有统计学显著改善。FMA-WH 从 41%提高到 54%。
初步结果表明,基于任务的 MT 对改善慢性中风患者腕部和手部运动功能恢复是有效的。需要进一步的随机试验研究来验证其有效性。