The effects of mirror therapy on hand functions of adults with hemiplegic serebral palsy

The aim of our study was to determine the effect of mirror therapy on muscle tone, motor improvement and functional status in standard treatment in patients with hemiplegic cerebral palsy (CP). A total of 50 patients aged between 16-40 years were enrolled into the study. All patients continued their standard treatment for 8 weeks in a special training center for 2 days per week for 40 minutes.In the mirror group (n=25), 20 minutes of the 40-minute sessions, standard treatment and 20 minutes of mirror therapy were applied. Muscle tone in wrist and elbow flexor muscles wereassessed by Modified Ashworth Scale (MAS), wrist and elbow joint range of motion (ROM) with goniometer, upper extremity motor recoveryby Brunnstrom Motor Staging, gross manual dexterityby Box and Block Test (BBT), functional independence was evaluated by Functional Independence Measure (FIM). Evaluations were performed by the same physiotherapist before and after 8 weeks of treatment.Pre-treatment comparisons of groups revealed that mirror group's wrist extension ROM (p = 0.001) and forearm pronation ROM (p = 0.017) were significantly higher than the control group. Before and after within group comparisons revealed that BBT, upper extremity Brunnstrom and FIM scores increased significantly in both groups (p <0.05). Tonus reduction in wrist flexor muscles was significant in both groups (p <0.05). ROM increase in wrist extension (p=0.006) and forearm supination (p = 0.008) were significant only in the mirror group. When the groups were compared in terms ofchange scores, the BBT change score of the paretic side was significantly higher in the mirror group (p = 0.034). In this study, it was observed that mirror therapy in addition to standard rehabilitation program20 minutes per day, 2 days a week, for 8 weeks was more effective than standard treatment alone in terms of gross manual dexterity in adult patients with hemiplegic CP. Key words: Hemiplegia, Cerebral palsy, Spasticity, Hand Functions, Mirror Treatment, Rehabilitation