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Effect of Mirror Therapy Combined with Lower Extremity Muscle Strength Exercise on Gait and Balance of Patients with Chronic Stroke

  • Kim, Myoung-Kwon (Dept. of Physical Therapy, College of Rehabilitation Sciences, Daegu University) ;
  • Shin, Young-Jun (Dept. of Physical Therapy, College of Rehabilitation Sciences, Daegu University) ;
  • Choi, Eun-Hong (Dept. of Physical Therapy, College of Rehabilitation Sciences, Daegu University)
  • Received : 2017.11.12
  • Accepted : 2017.12.31
  • Published : 2018.02.28

Abstract

PURPOSE: The present study aims to determine the effect of lower extremity muscle strength exercise at the non-paralyzed side of patients of stroke using a mirror on gait and balance. METHODS: Subjects were assigned randomly to a group of lower extremity exercise without using a mirror (n=10), a group of lower extremity motion exercise using a mirror (n=10), and a group of lower extremity muscle strength exercise using a mirror (n=10). The exercise is added to a physiotherapy program conducted at the hospital and subjects conducted their designed lower extremity exercises 30 times a day (5 sets), five days per week for four weeks. RESULTS: The study result showed that BBS(Berg balance scale)(p<.05) and TUG(timed up and go test)(p<.05) had a significant difference. In the comparison on gait ability, stride length, step length, step width and single support was a significant difference within two groups using a mirror before and after the intervention(p<.05). CONCLUSION: Conclusively, low extremity motion exercise using a mirror and low extremity muscle strength exercise using a mirror conducted along with general physiotherapy exercises had a positive effect on functions of lower extremity in patients with stroke and the recovery of paralyzed side thereby incurring a significant difference in balance and gait abilities.

Keywords

References

  1. Bhasin A, Srivastava P, Kumaran S, et al. Neural interface of mirror therapy in chronic stroke patients: a functional magnetic resonance imaging study. Neurolo India. 2012;60(6):570-6. https://doi.org/10.4103/0028-3886.105188
  2. Blanton S, Wolf SL. An application of extremity constraint induced movement therapy in a patient with subacute stroke. PhysTher. 1999;79:847-53.
  3. Carroll TJ, Herbert RD, Munn J, et al. Contralateral effects of unilateral strength training: evidence and possible mechanisms. J Applied Physio. 2006;101(5):1514-22. https://doi.org/10.1152/japplphysiol.00531.2006
  4. Coralie E, Susan H. Circuit class therapy for improving mobility after stroke: systematic review. J Rehabil Med. 2011;43:565-71. https://doi.org/10.2340/16501977-0824
  5. Cracies JM. Pathophysiology of spastic paralysis. I: paresis and soft tissue change. Muscle Nerve. 2005;31(5): 535-51. https://doi.org/10.1002/mus.20284
  6. Cramer SC, Bastings EP. Mapping clinically relevant plasticity after stroke. Neuropharmacol. 2000;39:842-51. https://doi.org/10.1016/S0028-3908(99)00258-0
  7. Hendricks HT, van Limbeek J, Geurts AC, et al. Motor recovery after stroke: a systematic review of the literature. Arch Phys Med Rehabil. 2002;83(11):1629-37. https://doi.org/10.1053/apmr.2002.35473
  8. Hesse S. Treadmill training with partial body weight support after stroke: a review. NeuroRehabil. 2008;22:1-11.
  9. Holm T, Maria B, Marco W, et al. Mirror therapy for patients with severe arm paresis after stroke: a randomized controlled trial. ClinRehabil. 2012;27(4):314-24.
  10. Ji SG. The effect of task oriented mirror therapy on balance and walking in subacute stroke patients. University of DongShin. 2013.
  11. Ji SG, Kim MK. The effects of mirror therapy on the gait of subacute stroke patients: a randomized controlled trial. ClinRehabil. 2015;29(4):348-54.
  12. Johansson BB. Brain plasticity and stroke rehabilitation. Stroke. 2006;31:223-30.
  13. Kim CH, Bang DH. Action observation training enhances upper extremity function in subacute stroke survivor with moderate impairment: a double-blind, randomized controlled pilot trial. J Korean SocPhys Med, 2016; 11(1):133-40.
  14. Kolb B, Gibb R. Brain plasticity and recovery from early cortical injury. Develop Psychobio. 2007;49:107-18. https://doi.org/10.1002/dev.20199
  15. Lee JH, Choi JD. Effects of intensive neuro rehabilitation intervention on the motor function recovery and balance in stroke patients. J Korean SocPhys Med, 2016; 11(4):41-7.
  16. Lee M, Gandevia SC, Caroll TJ. Unilateral strength training increases voluntary activation of the opposite untrained limb. ClinNeurophysio. 2009;120(4):802-8.
  17. Liepert J, Bauder H, Wolfgang HR, et al. Treatment induced cortical reorganization after stroke in humans. Stroke. 2000;31:1210-6. https://doi.org/10.1161/01.STR.31.6.1210
  18. Liston R, Brouwer B. Reliability and validity of measures obtained from stroke patients using the balance master. Arch Phys Med Rehabil. 1996;77(5):425-30. https://doi.org/10.1016/S0003-9993(96)90028-3
  19. Rizzolatti G, Fogassi L, Gallese V. Neurophysiological mechanisms underlying the understanding and imitation of action. Nat Rev NeuroSci. 2001;2:661-70. https://doi.org/10.1038/35090060
  20. Ryerson S, Levit K. Functional movement reduction: a complementary model for stroke rehabilitation. New York : Churchill Livingstone. 1997.
  21. Smorenburg ARP, Ledebt A, Deconinck FJA. Practicing a matching movement with a mirror in individuals with spastic hemiplegia. Research InDevelpDisabili. 2013; 34:2507-13.
  22. Sukanta KS, Chhanda S, Ratnesh K, et al. Functional electrical stimulation of dorsiflexor muscle: Effects on dorsiflexor strength, plantarflexor spasticity and motor recovery in stroke patients. NeuroRehabil. 2011;29: 393-400.
  23. Sutbeyaz S, Yavuzer G, Sezer N, et al. Mirror therapy enhances lower extremity motor recovery and motor functioning after stroke. Arch Phys Med Rehabil. 2007;88:555-9. https://doi.org/10.1016/j.apmr.2007.02.034
  24. Jung TY, Lee DK. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke. Arch Phys Med Rehabil. 2010;91:129-36. https://doi.org/10.1016/j.apmr.2009.09.012
  25. Talia H, Nir G, Leor G, et al. Six weeks of intensive treadmill training improves gait and quality of life in patients with Parkinson's disease: a pilot study. Arch Phys Med Rehabil. 2007;88:1154-58. https://doi.org/10.1016/j.apmr.2007.05.015
  26. Van Uden C, Besser M. Test-retest reliability of temporal and spatial gait characteristics measures with an instrumented walk way system(GAITRite). BMC Musculoskeletal Disorders. 2004;5:13. https://doi.org/10.1186/1471-2474-5-13
  27. Yavuzer G, Selles R, Sezer N, et al. Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2008; 89(3):393-8. https://doi.org/10.1016/j.apmr.2007.08.162
  28. You SH, Jang SH, Kim YH, et al. Virtual reality, induced cortical reorganization and associated locomotor recovery in chronic stroke. Stroke. 2005;36:1166-71. https://doi.org/10.1161/01.STR.0000162715.43417.91
  29. Zentgraf K, Stark R, Reiser M, et al. Differential activation of pre-SMA and SMA proper during action observation: effects of instructions. Neuroimage. 2005;26:662-72. https://doi.org/10.1016/j.neuroimage.2005.02.015