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Abstract
Objective: We explored the effectiveness of mirror therapy (MT) in the treatment of unilateral neglect in stroke patients.
Methods: This is an open, blinded endpoint, randomized controlled trial carried out from January 2011 to August 2013. We included stroke patients with thalamic and parietal lobe lesions with unilateral neglect 48 hours after stroke. Patients were randomized to the MT group or the control group (sham MT), and both the groups received limb activation. Patients received treatment for 1–2 hours a day 5 days a week for 4 weeks. The primary outcome was unilateral neglect assessed by a blinded assessor using the star cancellation test, the line bisection test, and a picture identification task at 1, 3, and 6 months. This study was registered at http://clinicaltrials.gov (NCT 01735877).
Results: Forty-eight patients were randomized to MT (n = 27) or the control group (n = 21). Improvement in scores on the star cancellation test over 6 months was greater in the MT group (mean difference 23, 95% confidence interval [CI] 19–28; p < 0.0001). Similarly, improvement in the MT group was observed in the scores on the picture identification task (mean difference 3.2, 95% CI 2.4–4.0; p < 0.0001) and line bisection test (mean difference 8.6, 95% CI 2.7–14.6; p = 0.006).
Conclusions: In patients with stroke, MT is a simple treatment that improves unilateral neglect.
Classification of evidence: This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes, MT improves neglect.
GLOSSARY
- CI=
- confidence interval;
- CMC=
- Christian Medical College;
- FIM=
- functional independence measure;
- LBT=
- line bisection test;
- mRS=
- modified Rankin scale;
- MT=
- mirror therapy;
- PIT=
- picture identification task;
- RCT=
- randomized controlled trial;
- SCT=
- star cancellation test;
- SMD=
- standardized mean difference
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received January 2, 2014.
- Accepted in final form June 17, 2014.
- © 2014 American Academy of Neurology
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- Mechanisms underlying mirror therapy and its clinical applications
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