Mirror therapy in the rehabilitation after stroke

Otprilike 80% osoba nakon moždanog udara doživi hemiparezu, odnosno motorička oštećenja ekstremiteta jedne strane tijela. Cilj ovog istraživanja bio je procijeniti učinke programa terapije zrcalom na motoričke funkcije gornjeg ekstremiteta kod jednog pacijenta s hemiparezom nakon moždanog udara. Pacijent je sudjelovao u terapiji zrcalom tijekom 6 dana, po 70 minuta dnevno. Funkcije gornjeg ekstremiteta su mjerene Box and Block Testom (BBT), Jebsen Hand Function Testom (JHFT) i Action Research Arm Testom (ARAT), prije i nakon 6 dana terapije. Kako bi se provjerila učinkovitost terapije zrcalom, jedan kontrolni ispitanik s hemiparezom je također bio procijenjen istim mjernim instrumentima, ali nije sudjelovao u terapiji zrcalom. Program terapije zrcalom se sastojao od dva dijela: vježbi bez rekvizita i vježbi s rekvizitima za ruku, šaku i prste. Učinci terapije zrcalom kod eksperimentalnog ispitanika uključuju statistički značajno poboljšanje na svim promatranim varijablama: manualna spretnost, fina motorika i funkcionalni pokreti. Terapija zrcalom je vrlo učinkovita metoda za poboljšanje motoričke funkcije gornjeg paretičnog ekstremiteta, kada se usporedi s rezultatima kontrolnog ispitanika koji nije postigao statistički značajan napredak niti na jednom instrumentu procjene. Budući da se smatra kako nezahvaćeni gornji ekstremitet može kod osoba nakon moždanog udara pokazivati motorički deficit u odnosu na ekstremitete zdravih osoba, također su uspoređeni rezultati procjene nezahvaćene ruke prije i nakon završetka terapije zrcalom. Rezultati pokazuju blagi napredak u motoričkoj funkciji nezahvaćenog ekstremiteta, a na varijabli manualna spretnost je taj napredak čak i statistički značajan. Terapija zrcalom je jednostavna i jeftina metoda za poboljšanje motoričkog oporavka gornjih ekstremiteta nakon moždanog udara.Approximately 80% of people experience hemiparesis, i.e. motor impairments of limbs on one side of the body after a stroke. The aim of this study was to evaluate effects of the mirror therapy on upper extremity motor functions in one patient with hemiparesis caused by a stroke. The patient participated in the mirror therapy during 6 weeks, 70 minutes a day. The upper extremity functions were measured by the Box and Block Test (BBT), the Jebsen Hand Function Test (JHFT) and the Action Research Arm Test (ARAT) before and after 6 days of therapy. In order to verify the effectiveness of the mirror therapy, one control subject with hemiparesis was evaluated with the same measuring instruments, but did not participate in the therapy. The therapy consisted of exercises without equipment and exercises with equipment for arm, hand and fingers. The effects of the mirror therapy in the experimental subject included statistically significant improvement in all observed variables: manual dexterity, fine motor skills and functional movements. Compared with the results of the control subject who did not achieve a statistically significant improvement on any assessment instrument, the mirror therapy has proved to be a highly effective method for improving the motor function of the upper paretic extremity. Since it is considered that the unaffected upper extremity can show motor deficit after a stroke when compared to the upper extremities of healthy people, the assessment results of the unaffected extremity before and after the mirror therapy were also compared. The results showed a mild improvement in the motor function of the unaffected extremity, with statistically significant improvement on the manual dexterity variable. The mirror therapy is a simple and inexpensive method to improve motor recovery of the upper extremities after a stroke