Mirror therapy for upper limb rehabilitation in chronic patients after stroke

Abstract Introduction: Individuals with stroke sequelae present changes in the postural alignment and muscle strength associated with hemiplegia or hemiparesis. Mirror therapy is a technique that aims to improve the motor function of the paretic limb. Objective: The aim of this study was to evaluate the effect of mirror therapy, associated with conventional physiotherapy, for range of motion (ROM), degree of spasticity of the affected upper limb, and the level of independence in the activities of daily living (ADL) of chronic patients after stroke. Methods: This was a quasi-experimental (before and after) study. The study included ten stroke survivors undertaking physiotherapy and presenting with upper limb paresis. The following gauges were used for the present study: goniometry, the Modified Ashworth Scale, Fugl-Meyer and Barthel Index. Fifteen sessions were performed, each lasting 30 minutes, consisting of stretching of the flexor and extensor muscles of the wrist and elbow, pronators and supinators, followed by mirror therapy with gradual functional exercises. Results: Improvement was observed in all aspects studied, however with significant differences for ROM wrist extension (p = 0.04) and forearm supination (p = 0.03) Conclusion: It can be concluded that mirror therapy contributed to the participants' good performance in the aspects studied, mainly in relation to ROM of the affected upper limb.

摘要：脑卒中后遗症患者会出现与偏瘫或轻偏瘫相关的姿势对线及肌肉力量改变。镜像疗法是一种旨在改善患侧肢体运动功能的干预技术。
目的：本研究旨在评估镜像疗法联合常规物理疗法，对脑卒中慢性期患者患侧上肢的关节活动度（Range of Motion, ROM）、痉挛程度，以及日常生活活动能力（Activities of Daily Living, ADL）独立水平的影响。
方法：本研究为类实验性（前后对照）研究，纳入10名接受物理治疗且存在上肢轻瘫的脑卒中幸存者。本研究采用以下评估工具：量角器测量法、改良Ashworth量表、Fugl-Meyer评估量表以及Barthel指数。共开展15次治疗，每次时长30分钟，内容涵盖腕部与肘部的屈肌、伸肌及旋前肌、旋后肌的拉伸训练，随后辅以渐进式功能训练的镜像疗法干预。
结果：所有研究维度均观察到改善，但腕关节伸展活动度（p=0.04）与前臂旋后活动度（p=0.03）的改善具有统计学显著性差异。
结论：综上可知，镜像疗法可助力受试者在各研究维度中取得良好表现，尤其在患侧上肢关节活动度方面效果显著。