Mirror therapy and unilateral strength training for enhancing motor function after stroke in the lower extremity: A randomised controlled trial.
Supervisor: Dr Kenneth Monaghan
Funding Body: IOTI
Introduction: Both mirror therapy (Thieme et. al. 2012) and cross-education of strength (Dragert & Zehr 2013) have successfully promoted functional recovery post stroke. A recent systematic review by Zult et. al. (2014) shows evidence for the effectiveness of mirror therapy to enhance cross-education of strength for patients after stroke. Recommendations from this review, propose that a combination of unilateral strength training with mirror training can further accelerate functional recovery post stroke.
Objective: To evaluate the effects of mirror therapy, using motor imagery training, combined with unilateral strength training, on lower-extremity motor recovery and functioning of patients with sub-acute stroke.
Design: Randomized, assessor-blinded, 6-week trial, with follow-up at 3 months.
Setting: Health Science & Physiology Exercise Laboratory in IT Sligo.
Participants: A total of 16 adult (>18years) outpatients (8 men: 8 women) with hemiparesis after stroke who have been discharged from the Sligo General Hospital stroke unit.
Interventions: The combined mirror and unilateral strength training group will receive 5 sets of 5 maximum effort isometric repetitions held for 5 seconds (Dragert & Zehr 2013). The placebo group will receive a similar protocol with the non-reflecting side of the mirror used.
Objectives of the study:
- Evaluate the effects of mirror therapy combined with cross education strength on lower-extremity motor recovery and functioning in patients with sub-acute stroke.
- Explore how this new combination therapy compares to placebo condition.
- Identify any adverse effects of the new combination therapy.
In this study, we hypothesized that congruent visual feedback and motor imagery from the moving non-paretic lower extremity during unilateral strengthening, as provided by a mirror, would help restore the integrity of cortical processing and thereby restore function in the affected lower extremity during gait.