4 Reasons Why You Should Be Implementing Mirror Therapy in Your Stroke Patient's Rehabilitation Plan
What is Mirror Therapy?
Mirror therapy is a rehabilitation technique using a mirror for visual feedback of a moving limb. A patient will place the affected limb behind the mirror while observing the reflection of the unaffected limb perform movements. Because the unaffected limb is moving, through artificial feedback, the brain is tricked into thinking the affected limb is also moving. This technique may be used in the rehabilitation of upper or lower extremities. When a person suffers a stroke, they typically experience paralysis, ultimately losing function in part of the body which makes mirror therapy a great strategy in recovery.
1. Increased Motor Function, Motor Recovery, Ambulation and Balance
When administering mirror therapy, a practitioner will ask the patient to perform some type of movement, whether it be an activity of daily living (ADL), like squeezing a sponge or doing an exercise like flexion or extension. Using official testing such as the Fugl Meyer Motor Assessment, 6 Minute Walking Test, and Berg Balance Scale, recent research has shown participants had increased coordination, reaction time, static & dynamic balance (Wu, et al., 2013), ambulation velocity (Simpson, et al., 2019), as well as in ADL’s like reaching, grasping and hand manipulation (Kim, et al., 2016).
2. Increased Effectiveness in Addition to Conventional Therapies
There is plenty of evidence to prove that mirror therapy is effective, but it’s shown to be even more effective when given in addition to conventional therapies like physical or occupational therapy. Recent research has conducted studies in which participants received 60-120 minutes of conventional therapy each week in addition to 30 minutes of mirror therapy at the end of each session (Ikizler May, et al., 2020). Similarly, another study gave conventional therapy exercises to participants and the session lasted as long as it took the participant to complete. Additionally, mirror therapy was given for 60 minutes per week (Shah & Singaravelan, 2020). Both of these studies found a more significant increase in motor function, recovery, ambulation and voluntary control in comparison to the groups that only received conventional therapies. With mirror therapy being so accessible at a low cost, it’s a simple way to incorporate evidence-based practice into our rehabilitation programs, in order to further improve a patient’s recovery.
3. Cost Effective & Easily Accessible
Today, many treatments for various conditions come at a high cost and are not always available to every patient. Mirror therapy is an effective treatment that is inexpensive, and can be accessed at home. While in clinical treatment, a mirror box (pictured above) may be used but when the patient goes home, there may not be access to one of those. A mirror box can be purchased on Amazon for $64.99, though that may be an expensive option if not being used for a long term use. For a more short term use, a full length mirror can be purchased from Walmart for only $6.44 and used while secured against a sturdy surface.
4. A Non-Pharmacological Approach to Pain Control
While stroke patients can significantly benefit from mirror therapy, many other conditions can too. Some include phantom limb pain (PLP) and Chronic Regional Pain Syndrome Type 1. This technique is not just used for regaining function of a limb, but also a great option for controlling pain and potentially decreasing the amount of pain medication a patient will take.
The Future of Mirror Therapy
Current research is limited to trials exploring short term benefits of implementing mirror therapy for patients that suffered a stroke. Future studies would benefit from examining long term effectiveness to increase practical applications on patients also suffering sensory impairments. Healthcare is always evolving through research, finding new strategies to treat patients with and this is just one of those strategies. This just might be that extra aid your patient needs to facilitate a breakthrough in treatment, so maybe give it a try!
Additional Resources
https://www.saebo.com/blog/mirror-box-therapy-exercises-stroke-survivors/
https://www.npr.org/templates/story/story.php?storyId=101788221
https://www.stgeorges.nhs.uk/wp-content/uploads/2018/07/THE_MTCRPS_02.pdf
About the Author
Rianna LaFleche is a senior at Westfield State University majoring in Movement Science with a concentration in Sports Medicine and minor in Psychology. Her other research includes hippotherapy for children with cerebral palsy. She plans to continue her education in graduate school for Occupational Therapy. Contact her via email at r.lafleche99@gmail.com.
References
İkizler May, H., Özdolap, Ş., Mengi, A., & Sarıkaya, S. (2020). The effect of mirror
therapy on lower extremity motor function and ambulation in post-stroke patients: A prospective, randomized-controlled study. Turkish journal of physical medicine and rehabilitation, 66(2), 154–160. https://doi.org/10.5606/tftrd.2020.2719
Kim, K., Lee, S., Kim, D., Lee, K., & Kim, Y. (2016). Effects of mirror therapy
combined with motor tasks on upper extremity function and activities daily living
of stroke patients. Journal of physical therapy science, 28(2), 483–487.
https://doi.org/10.1589/jpts.28.483
Mirror Therapy. (2020, September 29). Physiopedia.
https://www.physio-pedia.com/index.php?title=Mirror_Therapy&oldid=252064
Simpson, D., Ehrensberger, M., Horgan, F., Blake, C., Roberts, D., Broderick, P., &
Monaghan, K. (2019). Unilateral dorsiflexor strengthening with mirror therapy to improve motor function after stroke: A pilot randomized study. Physiotherapy Research International, 24(4), N.PAG. https://doiorg.scroll.lib.westfield.ma.edu/10.1002/pri.1792
Shah, J. M., & Singaravelan, R.M. (2020). Effects of mirror therapy and motor imagery
technique on lower extremity motor function in sub-acute stroke. International Journal of Scientific Research and Education, 08(04), 8298-8309.
http://www.jsae.in/index.php/JSRE/article/view/970/937
Wu, C. Y., Huang, P. C., Chen, Y. T., Lin, K. C., & Yang, H. W. (2013). Effects of
mirror therapy on motor and sensory recovery in chronic stroke: a randomized controlled trial. Archives of physical medicine and rehabilitation, 94(6), 1023–1030. https://doi.org/10.1016/j.apmr.2013.02.007
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