Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis
Background: There is an increasing trend for researchers to combine mirror therapy with another rehabilitation therapy when treating the upper extremity of patients with stroke.Objective: To evaluate the synergistic effect of combined mirror therapy (MT) on the upper extremity in patients with strok...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-04-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00155/full |
| _version_ | 1798045916796551168 |
|---|---|
| author | Zhonghua Luo Yuqing Zhou He He Shanshan Lin Rui Zhu Zhen Liu Jiemei Liu Xiaoli Liu Shuping Chen Shuping Chen Jihua Zou Jihua Zou Qing Zeng Qing Zeng |
| author_facet | Zhonghua Luo Yuqing Zhou He He Shanshan Lin Rui Zhu Zhen Liu Jiemei Liu Xiaoli Liu Shuping Chen Shuping Chen Jihua Zou Jihua Zou Qing Zeng Qing Zeng |
| author_sort | Zhonghua Luo |
| collection | DOAJ |
| description | Background: There is an increasing trend for researchers to combine mirror therapy with another rehabilitation therapy when treating the upper extremity of patients with stroke.Objective: To evaluate the synergistic effect of combined mirror therapy (MT) on the upper extremity in patients with stroke and to judge efficacies of four combined mirror therapy subgroups [EMGBF group: electromyographic biofeedback (EMGBF) + MT; MG group: mesh glove (MG) + MT; AT group: acupuncture (AT) + MT; ES group: EMG-triggered electrical stimulation (ES) + MT].Methods: CNKI, Wan Fang, VIP, Web of Science, ScienceDirect, PubMed, OVID LWW, and Cochrane were used. We searched these databases for randomized controlled trials published from January 2013 to August 2019, which presented results of combining mirror therapy with other rehabilitation therapies. Quality assessments were performed using the Cochrane Handbook criteria in order to accurately review interventions. The primary outcomes were measured by the Fugl–Meyer Assessment—upper extremity (FMA-UE).Results: Ten trials, with a total of 444 patients whose upper limb functions were damaged after stroke, were included in the meta-analysis. Compared with the control group, a remarkable effect of combined mirror therapy [all: weight mean difference in random effects model (WMD): 8.07, 95% confidence interval (CI) 5.87, 10.26] on functional recovery of the upper limb was detected. However, a high value of heterogeneity (χ2 = 20.09, df = 9; I2 = 55%) was found. The subgroup analysis (EMGBF group: WMD = 8.95, 95% CI 6.33, 11.58; ES group: WMD = 10.14, 95% CI: 5.67, 15.01) showed moderate improvement in functional recovery of the upper extremity in patients with stroke when mirror therapy was combined with conventional therapy. Furthermore, no difference in efficacy on upper extremity in patients with stroke was observed between the EMGBF group and the ES group.Conclusion: Despite the heterogeneity, the results indicate that combining mirror therapy with another rehabilitation therapy on the upper extremity in patients with stroke is better than single rehabilitation therapy. However, more randomized controlled clinical trials and larger sample sizes are required for an in-depth meta-analysis. |
| first_indexed | 2024-04-11T23:28:59Z |
| format | Article |
| id | doaj.art-665e25a172084eda92680a0bc8926b73 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T23:28:59Z |
| publishDate | 2020-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-665e25a172084eda92680a0bc8926b732022-12-22T03:57:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-04-011110.3389/fneur.2020.00155516890Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-AnalysisZhonghua Luo0Yuqing Zhou1He He2Shanshan Lin3Rui Zhu4Zhen Liu5Jiemei Liu6Xiaoli Liu7Shuping Chen8Shuping Chen9Jihua Zou10Jihua Zou11Qing Zeng12Qing Zeng13First Clinical Medical College, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, The First People's Hospital of Foshan, Foshan, Guangdong, ChinaDepartment of Rehabilitation Medicine, Shunde Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaSchool of Rehabilitation Medicine, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaSchool of Rehabilitation Medicine, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaSchool of Rehabilitation Medicine, Southern Medical University, Guangzhou, ChinaBackground: There is an increasing trend for researchers to combine mirror therapy with another rehabilitation therapy when treating the upper extremity of patients with stroke.Objective: To evaluate the synergistic effect of combined mirror therapy (MT) on the upper extremity in patients with stroke and to judge efficacies of four combined mirror therapy subgroups [EMGBF group: electromyographic biofeedback (EMGBF) + MT; MG group: mesh glove (MG) + MT; AT group: acupuncture (AT) + MT; ES group: EMG-triggered electrical stimulation (ES) + MT].Methods: CNKI, Wan Fang, VIP, Web of Science, ScienceDirect, PubMed, OVID LWW, and Cochrane were used. We searched these databases for randomized controlled trials published from January 2013 to August 2019, which presented results of combining mirror therapy with other rehabilitation therapies. Quality assessments were performed using the Cochrane Handbook criteria in order to accurately review interventions. The primary outcomes were measured by the Fugl–Meyer Assessment—upper extremity (FMA-UE).Results: Ten trials, with a total of 444 patients whose upper limb functions were damaged after stroke, were included in the meta-analysis. Compared with the control group, a remarkable effect of combined mirror therapy [all: weight mean difference in random effects model (WMD): 8.07, 95% confidence interval (CI) 5.87, 10.26] on functional recovery of the upper limb was detected. However, a high value of heterogeneity (χ2 = 20.09, df = 9; I2 = 55%) was found. The subgroup analysis (EMGBF group: WMD = 8.95, 95% CI 6.33, 11.58; ES group: WMD = 10.14, 95% CI: 5.67, 15.01) showed moderate improvement in functional recovery of the upper extremity in patients with stroke when mirror therapy was combined with conventional therapy. Furthermore, no difference in efficacy on upper extremity in patients with stroke was observed between the EMGBF group and the ES group.Conclusion: Despite the heterogeneity, the results indicate that combining mirror therapy with another rehabilitation therapy on the upper extremity in patients with stroke is better than single rehabilitation therapy. However, more randomized controlled clinical trials and larger sample sizes are required for an in-depth meta-analysis.https://www.frontiersin.org/article/10.3389/fneur.2020.00155/fullmirror therapycombined therapyupper limbstrokefunctional recovery |
| spellingShingle | Zhonghua Luo Yuqing Zhou He He Shanshan Lin Rui Zhu Zhen Liu Jiemei Liu Xiaoli Liu Shuping Chen Shuping Chen Jihua Zou Jihua Zou Qing Zeng Qing Zeng Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis Frontiers in Neurology mirror therapy combined therapy upper limb stroke functional recovery |
| title | Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis |
| title_full | Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis |
| title_fullStr | Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis |
| title_short | Synergistic Effect of Combined Mirror Therapy on Upper Extremity in Patients With Stroke: A Systematic Review and Meta-Analysis |
| title_sort | synergistic effect of combined mirror therapy on upper extremity in patients with stroke a systematic review and meta analysis |
| topic | mirror therapy combined therapy upper limb stroke functional recovery |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00155/full |
| work_keys_str_mv | AT zhonghualuo synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT yuqingzhou synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT hehe synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT shanshanlin synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT ruizhu synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT zhenliu synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT jiemeiliu synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT xiaoliliu synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT shupingchen synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT shupingchen synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT jihuazou synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT jihuazou synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT qingzeng synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis AT qingzeng synergisticeffectofcombinedmirrortherapyonupperextremityinpatientswithstrokeasystematicreviewandmetaanalysis |