This study investigates the effect of combining both mirror therapy with Electrical Stimulation (ES) on improvement of the function of lower extremity compared to conventional therapy. 18 stroke survivors (sub acute stage) were recruited, 9 of them were randomly assigned to receive conventional treatment and another 9 started the mirror therapy combined with ES treatment. Duration of each session in both interventions was 50 minutes, done 4 times per week over two weeks. After 2 weeks, subjects took one week rest before switching they type of treatment; those started with conventional therapy continued with mirror therapy combined with ES, and vice versa. The duration of this phase was 2 weeks with same schedule as the 1st one. Ankle dorsi-flexion range of motion, lower extremity sensory-motor function, and walking duration were measured at baseline, after 1st 2 weeks, and immediately after the last two weeks, and 4 weeks after end of training (retention test). Repeated Measures ANCOVA was done to compare outcome measures scores in both groups and between all testing days, and paired T-test was used measure the difference between groups. Significant increase in all outcome measures was found after the (MT+ES) training, which is higher than conventional therapy training (p<;0.0001). In conclusion, the results suggest that combination of mirror therapy and ES is more effective than conventional therapy in improving lower limb motor function after stroke.
Stroke is a sudden loss of the blood supply to brain tissues where a focal neurological disturbance of brain function rapidly develops. The symptoms of stroke last more than 24 hours and depend on the area of the brain that has been affected. Lower-extremity motor function after stroke is often impaired, causing restrictions in function, gait, and postural performance . Because ankle is one of the most important joints in gait, especially related to dorsiflexion movement , the gait performance is highly diminished as a result of ankle movement impairment . Recovery is most prominent within the first three to six months after stroke. Thus, implementation of intensive therapy within this duration post stroke can lead to faster improvement in activities . Conventional treatment approaches (like Brunnstrom’s approach or Bobath’s approach) for hemiplegic patients have been used for many years, even though they are not always evidence-based and their neurophysiologic background is poorly investigated. On the other hand, several promising rehabilitation approaches have been recently developed addressing the motor recovery and balance of lower extremity in stroke; such as virtual reality, mental imagery, robotic interactive therapy, electrical stimulation, and mirror therapy .
Source: Mirror therapy combined with functional electrical stimulation for rehabilitation of stroke survivors’ ankle dorsiflexion – IEEE Xplore Document