Can Hand Function be Improved for Stroke Patients?

Up to 85 percent of stroke victims experience paralysis of one side of the body.  One-half to three-fourths of survivors have continued limitation in their upper extremity. In a study completed in March 2008, it was found that hand function in stroke rehab patients improved more after using an innovative mirror therapy in addition to a conventional program. The comparison was made between the group receiving mirror therapy and a control group directly after four weeks of therapy and at a six-month follow-up point. Mirror therapy was not shown to help spasticity.

Conventional rehabilitation programs include methods such as exercise training of the paralyzed hand, functional electrical stimulation, robotic-assisted rehab, impairment-oriented training of the arm, and bilateral (both) arm training. If you or a loved one has had a stroke, you already know that this requires a lot of intense work, both on the part of the patient and the therapist.

Mirror therapy treatment was originally designed to relieve "phantom limb" pain (pain that occurs in the missing limb) in amputees. A mirror is used to hide the missing limb and only show the remaining functional limb. The patient is told to watch in the mirror while he/she follows instructions to move the limb that is still intact. This was a very successful method of relieving phantom pain, because the patient had the sensation that he could move and relax the "cramped" missing limb. It was thought that this treatment worked by helping the brain "re-wire" itself. It was for that reason that studies were directed at seeing whether or not the same concept would work to help brains that had lost connections due to stroke. Stroke destroys neurological pathways when brain tissue dies from lack of blood supply (oxygen and glucose).

The March 2008 study compared two groups of stroke rehab patients. Both groups received conventional stroke rehab. One of the groups additionally had mirror therapy while the control group had "sham" therapy with the mirror turned the wrong way. Both groups were instructed to try to do the same exercises with the paralyzed hand while they were exercising the functional hand. The mirror therapy group was directed to watch the functioning hand in the mirror. The sham group could only see the functioning hand itself.

For further information, refer to "Mirror Therapy Improves Hand Function in Subacute Stroke: A Randomized Controlled Trial," Yavuzer, G MD PhD; Selles, R PhD; Sezer, N MD; Sutbeyaz, S MD; Bussmann, J PhD; Koseoglu, F MD; Atay, M MD; Stam, H MD PhD; Archives of Physical Medicine and Rehabilitation, Volume 89, Issue 3, March 2008.