Researching effect of mirror therapy on upper extremity motor improvement in patients with hemiplegia after stroke

Stroke is a serious health problem that leads to disability in survivors and effects the majority of the society with its high frequency of occurrence and its mortality. More than 60% of stroke patients complain about permanent neurological deficits that hampers daily activities. Paretic upper extremity is an unwanted case that is frequent for stroke patients and that increases activity limitation. It is reported in relevant studies that 85% of stroke patients experience hemiplegia, %55-75 of them experience limitation of upper extremity. The aim of stroke rehabilitation is to help the individual gain the highest level of functional independence and enhance the quality of life despite the current insufficiencies. The conventional treatment methods implemented for this purpose are mostly insufficient in recovery of upper extremity motor functions. Mirror therapy is a simple, inexpensive and above all patient oriented treatment that is aimed at improving upper-extremity motor function. The participants of this study are 31 stroke patients who were rehabilitated in Başkent University Physical Medicine and Rehabilitation clinic between the dates 20.07.2013 and 30.07.2014. 16 study group patients received 60-120 minutes of upper extremity rehabilitation program and additionally 20 minutes of upper extremity mirror treatment education 5 times per week for 4 weeks. 15 conventional treatment group patients received 60-120 minutes of conventional rehabilitation program and exercises for healthy upper extremity range of motion against the nonreflecting side of the mirror, 5 times per week for 4 weeks. The patients were evaluated at the beginning of the rehabilitation program (pre-treatment) and at the end of 4 weeks (post treatment). For upper extremity motor recovery, Brunnstorm method and Fugl-Meyer upper extremity motor function scale were used. The disability level of the patients was evaluated by means of Functional independence measure self care score (FIM). There was no statistically significant difference between groups regarding age, gender, dominant hand, paretic hand, cerebrovascular event type and duration of disease (respectively; p=0.981, p=0.376, p=0.325, p=0.576, p=0.083, p=0.586). Before therapy, there was no statistically significant difference between groups, regarding Brunnstrom recovery stage, Fugl-Meyer upper extremity motor function scale, Functional independence measure self care scores (respectively; p=0.393, p=0.526, p=0.862, p=0.464). After the treatment, there was no statistically significant difference between groups regarding Brunnstrom stage of upper extremity and hand, Functional independence measure self-care scores (respectively; p= 0.526, p=0.161, p=0.843). After the treatment, upper extremity Fugl-Meyer motor scale values of mirror treatment group were significantly higher compared to conventional therapy group (p=0.047). In conclusion, it was determined that implementing mirror therapy in addition to conventional therapy program in upper extremity rehabilitation has supplemental benefit for stroke patients in improving upper extremity motor function.