Clinician Article
Effects of mirror therapy on walking ability, balance and lower limb motor recovery after stroke: a systematic review and meta-analysis of randomized controlled trials.
PMID: 29644880
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Physical Medicine and RehabilitationRelevance - 6/7
Newsworthiness - 6/7 -
NeurologyRelevance - 5/7
Newsworthiness - 5/7 -
Family Medicine (FM)/General Practice (GP)Relevance - 4/7
Newsworthiness - 4/7 -
General Internal Medicine-Primary Care(US)Relevance - 4/7
Newsworthiness - 4/7 -
Internal MedicineRelevance - 4/7
Newsworthiness - 4/7
Abstract
OBJECTIVE: To investigate the effects of mirror therapy on walking ability, balance and lower limb motor recovery in patients with stroke.
METHOD: MEDLINE, EMBASE, Web of Science, CENTRAL, PEDro Database, CNKI, VIP, Wan Fang, ClinicalTrials.gov, Current controlled trials and Open Grey were searched for randomized controlled trials that investigated the effects of mirror therapy on lower limb function through January 2018. The primary outcomes included were walking speed, mobility and balance function. Secondary outcomes included lower limb motor recovery, spasticity and range of motion. Quality assessments were performed with the PEDro scale.
RESULTS: A total of 13 studies ( n = 572) met the inclusion criteria. A meta-analysis demonstrated a significant effect of mirror therapy on walking speed (mean difference (MD) 0.1 m/s, 95% confidence interval (CI): 0.08 to 0.12, P < 0.00001), balance function (standard mean difference (SMD) 0.66, 95% CI: 0.43 to 0.88, P < 0.00001), lower limb motor recovery (SMD 0.83, 95% CI: 0.62 to 1.05, P < 0.00001) and passive range of motion of ankle dorsiflexion (MD 2.07°, 95% CI: 082 to 3.32, P = 0.001), without improving mobility (SMD 0.43, 95% CI: -0.12 to 0.98, P = 0.12) or spasticity of ankle muscles (MD -0.14, 95% CI: -0.43 to 0.15, P = 0.35).
CONCLUSION: The systematic review demonstrates that the use of mirror therapy in addition to some form of rehabilitation appears promising for some areas of lower limb function, but there is not enough evidence yet to suggest when and how to approach this therapy.
Clinical Comments
General Internal Medicine-Primary Care(US)
This Study is predominantly of value to those in Rehabilitation medicine. It's a meta-analysis showing rather minimal value of mirror therapy for lower limb function recovery after a stroke.
General Internal Medicine-Primary Care(US)
I don't know whether the article is newsworthy, but the concept is very interesting.
Internal Medicine
Relates more to physical therapy and rehab specialists.
Neurology
This is yet another review from rehabilitation concluding with uncertainty due to small studies. Maybe the effort should be directed to doing RCTs of adequate power rather than reviewing small studies with low numbers and inadequate power.
Neurology
This review is very important. Walking ability and balance are very important in stroke recovery. The available treatment are limited. The use of systematic way in finding and appraising the evidence is the strength of this article. The result showed some promising aspects of mirror therapy. The available evidence has low to moderate methodology quality scoring. Further trials with better methodology and larger number of subject are warranted.
Physical Medicine and Rehabilitation
Good article that should be brought to attention of specialists.
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