Patrick Broderick

Current PhD Student

Mirror therapy and treadmill training for patients with chronic stroke: A pilot randomised controlled trial

Background: Previous lower-limb mirror therapy research has focused on non-weight bearing interventions with patients in seated positions. Objectives: The primary aim of this study was to investigate the effect and feasibility of a combination of mirror therapy and treadmill training on post-stroke lower-limb recovery compared to a placebo intervention. Methods: The mirror therapy and treadmill training group (n = 15) walked on the treadmill while viewing a reflection of their non-paretic limb in a mirror positioned in the mid-sagittal plane. The placebo group (n = 15) received no mirror visual feedback due to an altered mirror position. Primary outcome measures: Ten Metre Walk Test (10MWT) and Six Minute Walk Test (6MWT). Secondary outcome measures: Modified Ashworth Scale (MAS), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS) and London Handicap Scale (LHS). Feasibility was appraised by examining participant compliance and any adverse events. Results: No significant between group differences were demonstrated for the 10MWT, 6MWT, FMA-LE, BBS or LHS at post-training or 3-month follow-up assessment. A significant between group difference on the MAS was demonstrated in the reduction of ankle dorsiflexion muscle tone (p = 0.006) and ankle plantarflexion muscle tone (p = 0.01) in the mirror therapy group compared to the placebo group at post-training assessment but not at 3-month follow-up assessment. Twenty-eight participants attended 100% of sessions. There were no dropouts during the intervention phase. No major adverse event occurred but one patient reported a mild and transient sensory irregularity. Conclusion: Our study reveals that in our group of patients with chronic stroke, mirror therapy combined with treadmill training facilitated significant reductions in ankle muscle tone (p < 0.05) compared to a placebo intervention.

Papers

• Broderick P, Blake C, Horgan F, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomised controlled trial. Topics in Stroke Rehabilitation 2018 (under review).
• Simpson D, Ehrensberger M, Broderick P, Blake C, Horgan F, Hickey P, O Reilly J, Monaghan K. Cross education and mirror therapy improves lower extremity strength and function after stroke (under review).
• Ehrensberger M, Simpson D, Broderick P, Blake C, Horgan F, Hickey P, O Reilly J, Monaghan K Unilateral strength training and mirror therapy for chronic stroke patients: a randomised pilot study (under review).
• Broderick P, Blake C, Horgan F, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy and treadmill training enhance lower limb motor function and muscle tone in patients with chronic stroke: a pilot randomised controlled trial. Cerebrovascular Disease 2018 suppl (in press).
• Simpson D, Ehrensberger M, Broderick P, Blake C, Horgan F, Hickey P, O Reilly J, Monaghan K. Cross education of strength and mirror therapy for a patient with chronic stroke: A Case Report. Physiotherapy Practice & Research 2018 (in press).
• Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Gait & Posture. 2018 12; 63: 208-220. doi: 10.1016/j.gaitpost.2018.05.017. [Epub ahead of print] Review. PMID: 29775908.
• Broderick P, Horgan F, Blake C, Hickey P, O’Reilly J, Ehrensberger M, Simpson D, Roberts D, Monaghan K. Mirror therapy and treadmill training for a patient with chronic stroke: A case report. Physiotherapy Theory and Practice 2018; 28: 1-11. doi: 10.1080/09593985.2018.1453903. [Epub ahead of print]. PMID: 29589777.
• Ehrensberger M, Simpson D, Broderick P, Regan J, Nulty C, Monaghan K. Elbow extension and dorsiflexion average torque contractions are highly reliable. Hong Kong Journal of Physiotherapy 2017 (in press).
• Simpson D, Ehrensberger M, Broderick P, Horgan F, Blake C, Hickey P, O’Reilly J, Monaghan K. Unilateral strength training for enhancing upper and lower motor function after stroke: a randomised controlled trial. Cerebrovascular Disease 2017; 43 (suppl 1): 1-176 (page 157).
• Ehrensberger M, Simpson D, Broderick P, Monaghan K. Cross-education of strength has a positive impact on post-stroke rehabilitation: a systematic literature review. Topics in Stroke Rehabilitation 2016 23: 1-10.

Presentations

• Irish Heart Foundation: 21st Annual Stroke Conference. Conference Proceedings (Oral Presentation) Fri 27th April 2018. (Abstract ID PL5: 15). Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomised controlled trial. Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K.
• 27th European Stroke Conference Athens. Conference Proceedings (Poster with oral presentation) Wed 11th April 2018. Mirror therapy and treadmill training enhance lower limb motor function and muscle tone in patients with chronic stroke: a pilot randomised controlled trial. Broderick P, Blake C, Horgan F, O Reilly J, Ehrensberger M, Simpson D, Monaghan K. (Note: this abstract was awarded an ESRF Travel Grant for being in the top 8 submitted abstracts for authors aged under 35 years).
• IT Sligo Postgraduate Research Event. Conference Proceedings (Poster) Fri 13th April 2018. Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomised controlled trial. Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K.
• IT Sligo Postgraduate Research Event. Conference Proceedings (Poster) Fri 13th June 2017. Mirror therapy and treadmill training for patients with chronic stroke: A randomised controlled trial. Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Hickey P, O Reilly J, Monaghan K.
• IT Sligo Postgraduate Research Event. Conference Proceedings (Poster) Fri 13th June 2017. Unilateral strength training and mirror therapy for enhancing upper and lower limb motor function after stroke: a randomised controlled trial. Simpson D, Ehrensberger M, Broderick P, Horgan F, Blake C, Hickey P, O Reilly J, Monaghan K.
• 26th European Stroke Conference 2017 Berlin (Poster). Unilateral strength training and mirror therapy for enhancing upper and lower limb motor function after stroke: a randomised controlled trial. Simpson D, Ehrensberger M, Broderick P, Horgan F, Blake C, Hickey P, O’Reilly J, Monaghan K.
• Irish Heart Foundation: 20th Annual Stroke Conference. Conference Proceedings (Poster) Fri 10th March 2017 Poster Presentation. Mirror therapy and treadmill training for patients with chronic stroke. A randomised controlled trial. Broderick P, Ehrensberger M, Simpson D, Horgan F, Blake C, Hickey P, O Reilly J, Monaghan K.
• North West Health Innovation Corridor (NWHIC): 1st Annual Conference. Conference Proceedings (Poster) Thurs 29th Sept 2016. Mirror therapy and treadmill training in chronic stroke patients. Pilot data. Broderick P, Blake C, Horgan F, O Reilly J, Ehrensberger M, Simpson D, , Monaghan K.
• North West Health Innovation Corridor (NWHIC): 1st Annual Conference. Conference Proceedings (Poster) Thurs 29th Sept 2016. Cross-education of strength has a positive impact on post-stroke rehabilitation: a systematic literature review. Ehrensberger M, Simpson D, Broderick P, Monaghan k.
• North West Health Innovation Corridor (NWHIC): 1st Annual Conference. Conference Proceedings (Poster) Thurs 29th Sept 2016. Mirror Therapy and unilateral strength training for enhancing motor function after stroke: a pilot randomised controlled trial. Ehrensberger M, Simpson D, Broderick P, Monaghan K.
• Irish Heart Foundation: 19th Annual Stroke Conference. Conference Proceedings Fri 8th April 2016. Cross-education of strength has a positive impact on post-stroke rehabilitation: a systematic literature review. Ehrensberger M, Simpson D, Broderick P, Monaghan K.
• Irish Heart Foundation: 19th Annual Stroke Conference. Conference Proceedings (Poster) Fri 8th April 2016. Mirror therapy and treadmill training in chronic stroke patients. Pilot data. Broderick P, Blake C, Horgan F, O Reilly J, Ehrensberger M, Simpson D, Monaghan K.
• Research & Education Foundation. 16th Annual Multidisciplinary Research Conference Sligo University Hospital Fri 27th November 2015 (Poster). Cross-education of strength has a positive impact on post-stroke rehabilitation: a systematic literature review. Ehrensberger M, Simpson D, Broderick P, Monaghan K.
• Irish Heart Foundation: 18th Annual Stroke Conference. Conference Proceedings (Poster) Fri 27th March 2015. Mirror therapy and unilateral strength training for enhancing motor function of the upper and lower limb after stroke. A pilot randomised controlled trial. Ehrensberger M, Simpson D, Broderick P, Monaghan K.
• Irish Heart Foundation: 17th Annual Stroke Conference. Conference Proceedings (Poster) Fri 11th April 2014. Mirror therapy & treadmill training for enhancing motor function after stroke: A pilot randomised controlled trial. Broderick P, Blake C, Horgan F, Monaghan K.

Collaborations

Sligo University Hospital

School/DepartmentProgrammeSRC/RRG
Science PhD CHANCE

Funding

IOTI & Capacity Building Fund

Supervisor(s)

Dr. Ken Monaghan.