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Physiotherapy and Occupational Therapy Journal

Volume  12, Issue 1, January-March 2019, Pages 59-67
 

Original Article

Mirror Therapy and Repetitive Facilitation Exercise Improve the Upper Extremity Motor Recovery in Hemiparesis Patients

Sudha Dhami1, Niraj Kumar2, Niranjan Kumar3, Anirban Patra4, Nishu Sharma5, Archana Chauhan6

1Lecturer 2,6Associate Professor 4,5Assistant Professor, Dept. of Physiotherapy, Shri Guru Ram Rai Institute of Medical & Health Sciences, Patel Nagar Dehradun, Uttarakhand 248001, India. 3Assistant Professor, Dept. of Physiotherapy, William Carey University, Opposite St. Anthony College, Police Bazar Shilling, Meghalaya 793009, India.

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DOI: DOI: http://dx.doi.org/10.21088/potj.0974.5777.12119.8

Abstract

 Introduction: Stork is a global epidemic and an important cause of morbidity and mortality. As defined by WHO stroke is “rapidly developing clinical sings of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, no apparent cause other that of vascular origin” [1]. Mirror therapy is a relatively new therapeutic intervention which is simple, inexpensive and most importantly patient directed treatment that focuses on moving the unimpaired limb. It was first introduced by Ramachandran and Roger Ramachandran to treat phantom limb pain after amputation [2]. In stroke patients, this technique involves performing of unimpaired limb while watching its mirror reflection superimposed over the (unseen) impaired limb, thus creating a visual illusion of enhanced movement capability of the impaired limb [2]. Aim of the Study: To analyze the effectiveness of combine motor rehabilitation protocol to improve upper extremity motor recovery in post stroke subjects. Methods: A total of forty subjects were selected based upon the inclusion and exclusion criteria. The 20 out of the 40 subjects were asked to maintain static joint posture for the neck. The postures included were flexion, extension, right and left side flexion and right and left rotation. The subjects were asked to maintain this posture in the sitting position. The remaining 20 subjects were asked to maintain the same static joint posture in sitting position for the neck but in reverse order. The first 20 subjects were then asked to maintain static joint posture for the low back in sitting position. The postures included were flexion, right and left side flexion and right and left rotation. The remaining 20 subjects were then asked to maintain the same static joint posture for the low back in sitting position but in the reverse order. Discussion: Mirror therapy and RFE relatively a new treatment techniques developed to promote upper extremity recovery in stroke patients. Previous studies in stroke suggested that MT and RFE may be beneficial for motor function and is a simple, inexpensive and most importantly patient directed treatment that improve upper extremity function. Hun-Chiaet 2010 and Gunes Yavuzer in 2008, supported that UEFI is a preferred upper limb regional tool due to its superior and comparable psychometric properties. The result of the study confirm that the MT and RFE has improved upper limb function as demonstrated with UEFI. Clinically this study demonstrated that by using MT and RFE as a treatment tool, the improvement was seen in upper extremity functional activity of post stroke hemiparetic subjects. Conclusion: Mirror therapy and repetitive facilitation was found to be effective in improving functional independence in upper limb post sub –acute stroke. When mirror therapy and repetitive is administe 3rd to patient suffering from sub-acute stroke over a period of 4 weeks, it results in an improvement in reaching forwards, grasping, manipulating objects and also improves others fine motor functions of the hand. Limitations of the Study: The duration of study was only 4 weeks, Home exercise were not prescribed to the subjects and Training depending on functional level of patients.

Keywords: Mirror box; Table; Chair; Ball; Jar; Bag; Comb; Suitcase; Treatment couch; Shirt with buttons and Shoes with laces.


Corresponding Author : Niraj Kumar