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镜像疗法对亚急性脑卒中上肢运动及功能恢复的影响:系统评价与Meta分析

Effects of mirror therapy on motor and functional recovery of the upper extremity in subacute stroke: Systematic review and meta-analysis.

作者信息

Hsieh Yuan-Lun, Yang Tzu-Ying, Peng Zi-You, Wang Ray-Yau, Shih Hui-Ting, Yang Yea-Ru

机构信息

Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

PM R. 2025 May;17(5):567-581. doi: 10.1002/pmrj.13316. Epub 2025 Jan 24.

Abstract

OBJECTIVE

To review and synthesize existing evidence on the effect of mirror therapy (MT) on motor and functional recovery and the effect of unimanual and bimanual MT in individuals with subacute stroke.

METHODOLOGY

PubMed, Physiotherapy Evidence Database, Cochrane, and Airiti Library were searched for relevant studies. Randomized and pilot randomized controlled trials comparing MT with sham MT or conventional therapy were included. Three researchers independently reviewed eligible studies for study design, participants' characteristics, intervention, and outcome measures and assessed study quality. The Physiotherapy Evidence Database scale was used to evaluate the methodological quality of included studies, and the Cochrane Risk of Bias Tool was used to assess the risk of bias.

SYNTHESIS

Fifteen studies with 546 participants were included. An overall effect of MT was found for motor impairment (effect size [95% confidence interval]: 0.473 [0.274-0.673], p < .001), motor function (0.266 [0.059-0.474], p = .012), and activities of daily living (ADL) (0.461 [0.25-0.671], p < .001), compared with controls. There was a significant difference in motor impairment (0.39 [0.134-0.647], p = .003), motor function (0.298 [0.003-0.593], p = .048), and ADL (0.461 [0.157-0.766], p = .003) in favor of bimanual MT compared with controls. No significant effect was found for unimanual MT.

CONCLUSION

MT, specifically bimanual MT, is an effective intervention for improving motor recovery, motor function, and ADL in individuals with subacute stroke, whereas unimanual MT does not show significant benefits in these areas.

摘要

目的

回顾并综合现有证据,探讨镜像疗法(MT)对亚急性中风患者运动和功能恢复的影响,以及单手和双手MT的效果。

方法

检索PubMed、物理治疗证据数据库、Cochrane图书馆和华艺数位图书馆以查找相关研究。纳入比较MT与假MT或传统疗法的随机和试点随机对照试验。三位研究人员独立审查符合条件的研究,以了解研究设计、参与者特征、干预措施和结果测量,并评估研究质量。使用物理治疗证据数据库量表评估纳入研究的方法学质量,并使用Cochrane偏倚风险工具评估偏倚风险。

综合分析

纳入了15项研究,共546名参与者。与对照组相比,发现MT对运动障碍(效应大小[95%置信区间]:0.473[0.274 - 0.673],p < 0.001)、运动功能(0.266[0.059 - 0.474],p = 0.012)和日常生活活动(ADL)(0.461[0.25 - 0.671],p < 0.001)有总体效果。与对照组相比,双手MT在运动障碍(0.39[0.134 - 0.647],p = 0.003)、运动功能(0.298[0.003 - 0.593],p = 0.048)和ADL(0.461[0.157 - 0.766],p = 0.003)方面有显著差异,有利于双手MT。未发现单手MT有显著效果。

结论

MT,特别是双手MT,是改善亚急性中风患者运动恢复、运动功能和ADL的有效干预措施,而单手MT在这些方面未显示出显著益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dfc/12065093/995a2d6683cf/PMRJ-17-567-g005.jpg

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