Effects of a Mirror-Induced Visual Illusion on a Reaching Task in Stroke Patients: Implications for Mirror Therapy Training. (September 2014)

• Record Type: Journal Article
• Authors: Selles, Ruud W.; Michielsen, Marian E.; Bussmann, Johannes B. J.; Stam, Henk J.; Hurkmans, Henri L.; Heijnen, Iris; de Groot, Danielle; Ribbers, Gerard M.
• Is Part Of: Neurorehabilitation & neural repair. Volume 28:Number 7(2014)
• Page Start: 652
• Page End: 659
• Publication Date: 2014-09
• Subjects: stroke -- upper limbs -- rehabilitation -- recovery of function -- physical therapy; Nervous system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Patients -- Rehabilitation -- Periodicals; Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation -- Periodicals; Nervous system -- Regeneration -- Periodicals; Neuroplasticity -- Periodicals; 616.804305
• DOI: 10.1177/1545968314521005
• Languages: English
• ISSNs: 1545-9683

Abstract

Background . Although most mirror therapy studies have shown improved motor performance in stroke patients, the optimal mirror training protocol still remains unclear. Objective . To study the relative contribution of a mirror in training a reaching task and of unilateral and bimanual training with a mirror. Methods . A total of 93 stroke patients at least 6 months poststroke were instructed to perform a reaching task as fast and as fluently as possible. They performed 70 practice trials after being randomly allocated to 1 of 5 experimental groups: training with (1) the paretic arm with direct view (Paretic-No Mirror), (2) the nonparetic arm with direct view (Nonparetic-No Mirror), (3) the nonparetic arm with mirror reflection (Nonparetic Mirror), (4) both sides and with a nontransparent screen preventing visual control of paretic side (Bilateral-Screen), and (5) both sides with mirror reflection of the nonparetic arm (Bilateral-Mirror). As baseline and follow-up, patients performed 6 trials using only their paretic side. Primary outcome measure was the movement time. Results . We found the largest intervention effect in the Paretic-No Mirror condition. However, the Nonparetic-Mirror condition was not significantly different from the Paretic-No Mirror condition, while the Unaffected-No Mirror condition had significantly less improvement than the Paretic-No Mirror condition. In addition, movement time improved significantly less in the bimanual conditions and there was no difference between both bimanual conditions or between both mirror conditions. Conclusion . The present study confirms that using a mirror reflection can facilitate motor learning. In this task, bimanual movement using mirror training was less effective than unilateral training.