Motor Recovery and Cortical Reorganization After Mirror Therapy in Chronic Stroke Patients A Phase II

Well at least some semblance of a protocol, but not enough. For fingers, do I do them individually or as a group first and then individually? How many repetitions?

WHOM in stroke leadership are you contacting to get future research and protocol creation done? Specific names only, I want to hold their feet to the fire.

Motor Recovery and Cortical Reorganization After Mirror Therapy in Chronic Stroke Patients A Phase II

Show all authors

Marian E. Michielsen, MSc, Ruud W. Selles, PhD, Jos N. van der Geest, PhD, ...

First Published November 4, 2010 Research Article Find in PubMed 

https://doi.org/10.1177/1545968310385127

Article information

   

Abstract

Objective. 

To evaluate for any clinical effects of home-based mirror therapy and subsequent cortical reorganization in patients with chronic stroke with moderate upper extremity paresis.  

Methods. 

A total of 40 chronic stroke patients (mean time post .onset, 3.9 years) were randomly assigned to the mirror group (n = 20) or the control group (n = 20) and then joined a 6-week training program. Both groups trained once a week under supervision of a physiotherapist at the rehabilitation center and practiced at home 1 hour daily, 5 times a week. The primary outcome measure was the Fugl-Meyer motor assessment (FMA). The grip force, spasticity, pain, dexterity, hand-use in daily life, and quality of life at baseline—post treatment and at 6 months—were all measured by a blinded assessor. Changes in neural activation patterns were assessed with functional magnetic resonance imaging (fMRI) at baseline and post treatment in an available subgroup (mirror, 12; control, 9).  

Results. 

Post treatment, the FMA improved more in the mirror than in the control group (3.6 ± 1.5, P < .05), but this improvement did not persist at follow-up. No changes were found on the other outcome measures (all Ps >.05). fMRI results showed a shift in activation balance within the primary motor cortex toward the affected hemisphere in the mirror group only (weighted laterality index difference 0.40 ± 0.39, P < .05).  

Conclusion. 

This phase II trial showed some effectiveness for mirror therapy in chronic stroke patients and is the first to associate mirror therapy with cortical reorganization. Future research has to determine the optimum practice intensity and duration for improvements to persist and generalize to other functional domains.