Combining afferent stimulation and mirror therapy for rehabilitating motor function, motor control, ambulation, and daily functions after stroke

• Published in: Neurorehabilitation and neural repair Vol. 28; no. 2; p. 153
• Main Authors: Lin, Keh-chung, Huang, Pai-chuan, Chen, Yu-ting, Wu, Ching-yi, Huang, Wen-ling
• Format: Journal Article
• Language: English
• Published: United States 01.02.2014
• Subjects: Activities of Daily Living; Chronic Disease - therapy; Combined Modality Therapy; Electric Stimulation; Feedback, Sensory; Female; Humans; Male; Middle Aged; Movement Disorders - rehabilitation; Single-Blind Method; Stroke Rehabilitation; Treatment Outcome; Visceral Afferents - physiology; stroke rehabilitation; electrical stimulation; kinematics; activities of daily living; mirror therapy
• ISSN: 1552-6844
• DOI: 10.1177/1545968313508468

Mirror therapy (MT) and mesh glove (MG) afferent stimulation may be effective in reducing motor impairment after stroke. A hybrid intervention of MT combined with MG (MT + MG) may broaden aspects of treatment benefits. To demonstrate the comparative effects of MG + MT, MT, and a control treatment (CT) on the outcomes of motor impairments, manual dexterity, ambulation function, motor control, and daily function. Forty-three chronic stroke patients with mild to moderate upper extremity impairment were randomly assigned to receive MT + MG, MT, or CT for 1.5 hours/day, 5 days/week for 4 weeks. Outcome measures were the Fugl-Meyer Assessment (FMA) and muscle tone measured by Myoton-3 for motor impairment and the Box and Block Test (BBT) and 10-Meter Walk Test (10 MWT) for motor function. Secondary outcomes included kinematic parameters for motor control and the Motor Activity Log and ABILHAND Questionnaire for daily function. FMA total scores were significantly higher and synergistic shoulder abduction during reach was less in the MT + MG and MT groups compared with the CT group. Performance on the BBT and the 10 MWT (velocity and stride length in self-paced task and velocity in as-quickly-as-possible task) were improved after MT + MG compared with MT. MT + MG improved manual dexterity and ambulation. MT + MG and MT reduced motor impairment and synergistic shoulder abduction more than CT. Future studies may integrate functional task practice into treatments to enhance functional outcomes in patients with various levels of motor severity. The long-term effects of MG + MT remain to be evaluated.