Effect of associated mirror therapy on the less affected hand in patients with subacute stroke: a pilot randomized controlled trial.

BACKGROUND

The ipsilesional hand after stroke has been shown to exhibit a minor deficit, impacting bimanual activities. This study investigates the effect of associated mirror therapy (AMT) on the less affected hand dexterity and explores the relationship between bilateral hand recovery poststroke.

METHODS

An assessor-blinded, pilot randomized controlled study was conducted. Patients were assigned to the AMT or control group, receiving 30-minute training per time, five times a week for four weeks. The primary outcome was the ipsilesional Box and Block Test (BBT_I). The secondary outcomes included the contralesional Box and Block Test (BBT_C), Fugl-Meyer Assessment for Upper Extremity and Hand (FMA_UE and FMA_H), and Functional Independent Measure (FIM). Assessments were conducted at baseline, after 2-week, and 4-week treatment.

RESULTS

All patients showed improved BBT_I, FMA_H, and FIM scores in the latter two weeks compared to the first two weeks (all P<0.05). The AMT group had higher FMA_H and FIM scores than the control group (P<0.001). Although the difference in BBT_I scores was insignificant (P=0.064), the AMT group performed better. Significant interaction effects were found in BBT_C and FMA_UE scores. The AMT group showed greater improvements in BBT_C and FMA_UE scores in 2-week and 4-week interventions than the control group (all P <0.05). Compared to the first two weeks, the AMT group showed improvements in FMA_UE and BBT_C scores during the last two weeks, while the control group only improved in FMA_UE scores (P<0.05). No correction was found in BBT_C and BBT_I change scores between bilateral hand recovery in either group during the first and the latter two weeks.

CONCLUSIONS

AMT improves affected upper limb and hand motor impairment, hand dexterity, and daily activities, potentially enhancing dexterity in the less affected hand poststroke. There is no relationship between bilateral hand recovery during 4-week inpatient rehabilitation of subacute stroke.