After stroke, patients frequently suffer from arm or hand weakness. There are numerous rehabilitation methods to stimulate recovery, amongst which mirror therapy (MT). It is particularly interesting in cases for which impairment is severe, as many other forms of therapy are often impossible.
During MT, a mirror is placed in the midsagittal plane, so as to hide the impaired limb. Thereafter, the subject is asked to move his unimpaired limb while looking at its reflection in the mirror, thereby creating the illusion that the contralateral, impaired limb is moving.
The objective of this study is to better determine the efficacy of MT. The investigators will therefore compare recovery of arm function in two groups of patient, that perform a regimen of 30 minutes of therapy, 5 times a week, for 4 weeks on top of conventional therapy. One group performs MT and the other one performs a therapy in which the same movements are performed, but without the use of a mirror, with unrestricted view of both limbs. Allocation to each group will be randomized. Arm function will be evaluated by use of a scale before, during and after the 4 week period. The assessor for the primary outcome measure will not know in which group the patient is. There will be a total of 30 patients included over a one year study period.
- Mirror therapy Device
Other Names: Mirror Designed by IT Sligo. Intervention Desc: Mirror therapy will consist in placing a large mirror in the sagittal plane of the subject so as to reflect his healthy arm while hiding the paretic one, and then asking him to perform movements of his healthy arm while looking at its reflection in the mirror. ARM 1: Kind: Experimental Label: Mirror Therapy (MT) Description: Standard therapy + 30 min/day of mirror therapy, 5 days/week, for 4 weeks, administered by experienced physical and occupational therapists.
- Control Therapy Other
Intervention Desc: Performance of the same movements as the experimental group without the mirror or instructions as to where to look, 5 days/week, for 4 weeks. ARM 1: Kind: Experimental Label: Control Therapy (CT) Description: Standard therapy + 30 min/day of CT.
|Type||Measure||Time Frame||Safety Issue|
|Primary||Change in Fugl Meyer Assessment - Upper Limb (FMA-UE)||Baseline, 2 weeks and 4 weeks after start of therapy. Additional follow-up visit min. 6 weeks after discharge from rehabilitation.|
|Secondary||Change in Functional Independence Measure (FIM)||Baseline, 2 weeks and 4 weeks after start of therapy. Additional follow-up visit min. 6 weeks after discharge from rehabilitation.|
|Secondary||Change in Bell cancellation task||Baseline, 2 weeks and 4 weeks after start of therapy. Additional follow-up visit min. 6 weeks after discharge from rehabilitation.|
|Secondary||Change in Line bisection task|
|Secondary||Change in Numeric pain scale|