The Effects of Mirror Therapy on Upper Extremity in Stroke Patients

Completed

Phase N/A Results N/A

Trial Description

The purpose of this study is to compare treatment efficacy of mirror therapy (MT), mirror therapy combining mesh glove (MG+MT) stimulation, and controlled treatment (CT) in people with stroke.

Detailed Description

55% to 75% of people after stroke have a paretic arm that causes motor impairment. Among novel rehabilitation interventions, MT was found to be beneficial and comparatively low-cost. MT reduced motor impairment possibly in part of recruiting the premotor cortex or balancing the neural activation within the primary motor cortex toward the affected hemisphere. However, the benefits in certain aspects of outcomes are under debate. Another treatment, MG, can be used to normalize muscle tone, suppress muscle spasticity, enhance residual volitional activity of hand and arm, or even increasing walking speed. In addition, providing MG stimulation might result in plastic changes in the primary motor cortex, and induced a long-lasting modulated effect on motor cortical excitability. The possible mechanism of brain plasticity underlying MG is collective with the mechanism behind the MT. Adding MG to MT might augment the cortical reorganization. In sum, combining MT with MG may supplement the disadvantage or uncertain effects of MT and broaden the benefited outcomes.

Conditions

Interventions

  • Mirror box training Behavioral
    Other Names: MT
    Intervention Desc: This protocol includes 1 hour mirror therapy and 0.5 hour functional training in a session. The treatment intensity is 1.5 hours/day, 5 days/week, for 4 weeks. MT focuses on symmetrical bimanual movements and simultaneously observing the visual feedback of the unaffected upper extremity reflected by the mirror.
    ARM 1: Kind: Experimental
    Label: Mirror therapy
    Description: mirror box training
    ARM 2: Kind: Experimental
    Label: Combined treatment
    Description: Mirror therapy combining mesh glove stimulation
    ARM 3: Kind: Experimental
    Label: Mirror therapy + Mesh glove stimulation
    Description: Mirror therapy combined with mesh glove stimulation
  • Mesh glove stimulation Other
    Other Names: MG
    Intervention Desc: The MG is a two-channel electrical stimulator providing synchronous or reciprocal sensory stimulation with variant amplitudes.
    ARM 1: Kind: Experimental
    Label: Combined treatment
    Description: Mirror therapy combining mesh glove stimulation
    ARM 2: Kind: Experimental
    Label: Mirror therapy + Mesh glove stimulation
    Description: Mirror therapy combined with mesh glove stimulation
  • Conventional intervention Behavioral
    Other Names: CI
    Intervention Desc: Participants in this group receive a structured protocol based on occupational therapy such as neuro-developmental techniques and task-oriented approach
    ARM 1: Kind: Experimental
    Label: Controlled intervention
    Description: conventional interventions

Trial Design

  • Allocation: Randomized
  • Masking: Single Blind (Investigator)
  • Purpose: Treatment
  • Endpoint: Efficacy Study
  • Intervention: Factorial Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Fugl-Meyer Assessment (FMA) Baseline, change from baseline in FMA at 4 weeks, change from baseline in FMA at 16 weeks, change from baseline in FMA at 28 weeks No
Primary Wolf Motor Function Test (WMFT) Baseline, change from baseline in WMFT at 4 weeks, change from baseline in WMFT at 16 weeks, change from baseline in WMFT at 28 weeks No
Primary Accelerometers Baseline, change from baseline in accelerometers at 4 weeks, change from baseline in accelerometers at 16 weeks, change from baseline in accelerometers at 28 weeks No
Primary revised Nottingham Sensory Assessment (rNSA) Baseline, change from baseline in rNSA at 4 weeks, change from baseline in rNSA at 16 weeks, change from baseline in rNSA at 28 weeks No
Secondary Kinematic analyses Baseline, change from baseline in kinematic parameters at 4 weeks No
Secondary Motor Activity Log (MAL) Baseline, change from baseline in MAL at 4 weeks, change from baseline in MAL at 16 weeks, change from baseline in MAL at 28 weeks No
Secondary Semmes-Weinstein monofilaments Baseline, change from baseline in Semmes-Weistein monofilaments at 4 weeks, change from baseline in Semmes-Weistein monofilaments at 16 weeks, change from baseline in Semmes-Weistein monofilaments at 28 weeks No
Secondary Functional Independence Measure (FIM) Baseline, change from baseline in FIM at 4 weeks, change from baseline in FIM at 16 weeks, change from baseline in FIM at 28 weeks No
Secondary Stroke Impact Scale version 3.0 (SIS 3.0) Baseline, change from baseline in SIS at 4 weeks, change from baseline in SIS at 16 weeks, change from baseline in SIS at 28 weeks No
Secondary 8-OHdG Baseline, change from baseline in 8-OHDG at 4 weeks, change from baseline in 8-OHDG at 16 weeks, change from baseline in 8-OHDG at 28 weeks No

Sponsors