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Neurological Rehabilitation

Comparing the Effects of Different Dosages of Lower Extremity Mirror Therapy on Stroke Recovery: A Randomized Controlled Trial

Thursday, November 16, 2023

    Primary Author(s)

  • Karisse Pugoy, MD

    Fellow in Training
    Philippine Academy of Rehabilitation Medicine
    Quezon City, National Capital Region, Philippines

    • Co-Author(s)

  • AG

    Antonette M. Gabua, MD

    Medical Specialist III
    Veterans Memorial Medical Center
    Quezon City, National Capital Region, Philippines

  • Mary Avegail A. Cacao, Consultant

    Consultant
    Philippine Academy of Rehabilitation Medicine
    Quezon City, National Capital Region, Philippines

  • Alex Zander Bondoc, MD

    Medical Specialist
    n/a
    Quezon City, National Capital Region, Philippines

Background and/or Objectives: Mirror therapy protocols in stroke rehabilitation have high variability in therapy dosages. We hypothesize that these different dosages result to different degrees of improvement. Our objective is to compare the effects of different dosages of mirror therapy on functional and motor recovery after stroke.

Design: Prospective non-blinded randomized control trial.

Setting: Physical therapy gym in a tertiary hospital.

Participants: 51 participants randomly assigned to the Normal Dose (ND) (n=17), Half Dose (HD) (n=17), Double Dose (DD) (n=17) groups.

Interventions: All participants underwent a conventional physical therapy program, 3x/week for 6.5 weeks, followed by a standardized mirror therapy session. ND group had an additional 30 minutes, while HD and DD groups had an additional 15 and 30 minutes, respectively.

Main Outcome Measures: Brunnstrom stages and Functional Ambulation Category (FAC) score at pre-treatment, post-treatment duration, and 1 month follow-up.

Results: Outcome measures within the 3 groups showed significant improvement in mean Brunnstrom stage and FAC scores from pre-treatment, to post-treatment, and follow-up (p=0.0001). The amount of change in mean Brunnstrom scores was similar among the groups in comparing pre-treatment to post-treatment (0.94±0.68 vs 0.82±0.73 vs. 1.21±0.8, p=0.334), post-treatment to follow-up (1.07±0.96 vs. 0.87±0.52 vs. 0.75±0.62, p=0.525), and pre-treatment to follow-up (1.93±0.88 vs 1.53±0.74 vs 2±0.74, p=0.251). Similarly, no significant differences were found on the amount of change in the mean FAC score for the same comparisons (1.06±0.68 vs. 0.71±1.1 vs. 0.93±0.62, p=0.478; 1.0±0.76 vs. 0.87±0.74 vs.1.5±0.67, p=0.079; 2.07±1.1 vs. 1.73±1.16 vs. 2.33±1.07, p=0.384).

Conclusions: Lower extremity mirror therapy is an effective adjunct in stroke rehabilitation. The findings of this study suggest that the effects of 15 minutes of mirror therapy are equivalent to that of longer treatment sessions. Choosing this shorter session duration may be advantageous for patients with decreased motivation and may help contribute to better patient participation.