Clinical Neurology: Research Article

Gámez Santiago A.B.a· Martínez Cáceres C.M.b· Hernández-Morante J.J.c

Author affiliations

aPhysiotherapy Service, “Sagrado Corazón” Hospital, Malaga, Spain
bIMIB – Experimental Pathology Service, Arrixaca Hospital, Murcia, Spain
cFaculty of Health and Life Sciences, Catholic University of Murcia, Murcia, Spain

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: October 18, 2021
Accepted: January 30, 2022
Published online: April 04, 2022

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 1

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE

Abstract

Introduction: The present work was carried out to determine the effectiveness of neuromuscular stimulation triggered by mirror therapy (MT) in older patients with post-stroke hemiplegia by two different intervention protocols, either intensively or spaced. Methods: A preliminary trial conducted on Spanish rehabilitation centres was conducted. Forty older patients (>70 years) with diagnosed post-stroke hemiplegia were randomly distributed to intensive intervention group (5 times/week for 6 weeks) or to spaced intervention group (3 times/week for 10 weeks), which underwent a similar number of MT sessions (n = 30). Muscle strength and activity were measured at baseline and at the end of treatment. Functional ability was also evaluated. Results: Although both interventions improved muscle activity parameters, intensive MT showed a significantly and statistically higher intervention effect on electromyographic activity (p < 0.001) and muscle strength (p < 0.001) than the spaced over time protocol. Attending to the Barthel Index scores, the effect on functionality was also greater in the intensive therapy group (p < 0.001), although the functional improvement measured by the Fugl-Meyer test was similar (p = 0.235). The effect of the interventions was independent of age and clinical antecedents. Conclusion: Intensive MT appears to be more effective than a more spaced over time therapy; therefore, at least in the older adults, this treatment protocol should be recommended in the post-stroke recovery of these patients. Further studies will confirm with certainty whether this treatment is the most suitable guideline for to treat these patients.

© 2022 S. Karger AG, Basel

References Donato J, Campigotto F, Uhlmann EJ, Coletti E, Neuberg D, Weber GM, et al. Intracranial hemorrhage in patients with brain metastases treated with therapeutic enoxaparin: a matched cohort study. Blood. 2015 Jul;126(4):494–9. Larivière S, Ward NS, Boudrias MH. Disrupted functional network integrity and flexibility after stroke: relation to motor impairments. Neuroimage Clin. 2018 Jan;19:883–91. Furlan L, Conforto AB, Cohen LG, Sterr A. Upper limb immobilisation: a neural plasticity model with relevance to poststroke motor rehabilitation. Neural Plast. 2016;2016:8176217. Saver JL. Optimal end points for acute stroke therapy trials: best ways to measure treatment effects of drugs and devices. Stroke. 2011 Aug;42(8):2356–62. Bonnyaud C, Pradon D, Bensmail D, Roche N. Dynamic stability and risk of tripping during the timed up and go test in hemiparetic and healthy subjects. PLoS One. 2015 Oct;10(10):e0140317. Balasubramanian CK, Neptune RR, Kautz SA. Foot placement in a body reference frame during walking and its relationship to hemiparetic walking performance. Clin Biomech. 2010 Jun;25(5):483–90. Derungs A, Amft O. Estimating wearable motion sensor performance from personal biomechanical models and sensor data synthesis. Sci Rep. 2020 Dec;10(1):11450. Ay H, Arsava EM, Andsberg G, Benner T, Brown RD, Chapman SN, et al. Pathogenic ischemic stroke phenotypes in the NINDS-stroke genetics network. Stroke. 2014 Dec;45(12):3589–96. Lackland DT, Roccella EJ, Deutsch AF, Fornage M, George MG, Howard G, et al. Factors influencing the decline in stroke mortality. Stroke. 2014 Jan;45(1):315–53. Feigin VL, Nichols E, Alam T, Bannick MS, Beghi E, Blake N, et al. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 Mar;18(4):459–80. Brookes RL, Crichton S, Wolfe CDA, Yi Q, Li L, Hankey GJ, et al. Sodium valproate, a histone deacetylase inhibitor, is associated with reduced stroke risk after previous ischemic stroke or transient ischemic attack. Stroke. 2018;49(1):54–61. Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, et al. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2018 Jul;7(7):CD008449. Demel SL, Kittner S, Ley SH, McDermott M, Rexrode KM. Stroke risk factors unique to women. Stroke. 2018;49(3):518–23. Benedek A, Cernica D, Mester A, Opincariu D, Hodas R, Rodean I, et al. Modern concepts in regenerative therapy for ischemic stroke: from stem cells for promoting angiogenesis to 3D-bioprinted scaffolds customized via carotid shear stress analysis. Int J Mol Sci. 2019 May;20(10):2574. Choi HS, Shin WS, Bang DH. Mirror therapy using gesture recognition for upper limb function, neck discomfort, and quality of life after chronic stroke: a single-blind randomized controlled trial. Med Sci Monit. 2019;25:3271–8. Imaizumi S, Asai T, Koyama S. Agency over phantom limb enhanced by short-term mirror therapy. Front Hum Neurosci. 2017 Oct;11:483. Stewart C, Subbarayan S, Paton P, Gemmell E, Abraha I, Myint PK, et al. Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: a systematic review. PLoS One. 2018 Oct;13(10):e0204774. Pedroli E, Serino S, Cipresso P, Pallavicini F, Riva G. Assessment and rehabilitation of neglect using virtual reality: a systematic review. Front Behav Neurosci. 2015 Aug;9:226. Sharpee TO, Destexhe A, Kawato M, Sekulić V, Skinner FK, Wójcik DK, et al. 25th annual computational neuroscience meeting: CNS-2016. BMC Neurosci. 2016 Aug;17(Suppl 1):54. Ito T, Brincat SL, Siegel M, Mill RD, He BJ, Miller EK, et al. Task-evoked activity quenches neural correlations and variability across cortical areas. PLoS Comput Biol. 2020 Aug;16(8):e1007983. Van Rensbergen G, Nawrot T. Medical conditions of nursing home admissions. BMC Geriatr. 2010 Jul;10(1):46. Bähr F, Ritter A, Seidel G, Puta C, Gabriel HHW, Hamzei F. Boosting the motor outcome of the untrained hand by action observation: mirror visual feedback, video therapy, or both combined-what is more effective? Neural Plast. 2018;2018:8369262. Lim KB, Lee HJ, Yoo J, Yun HJ, Hwang HJ. Efficacy of mirror therapy containing functional tasks in poststroke patients. Ann Rehabil Med. 2016;40(4):629–36. Fong KNK, Ting KH, Zhang JJQ, Yau CSF, Li LSW. Event-related desynchronization during mirror visual feedback: a comparison of older adults and people after stroke. Front Hum Neurosci. 2021 May;15:629592. Mayr S, Erdfelder E, Buchner A, Faul F. A short tutorial of GPower. Tutor Quant Methods Psychol. 2007;3(2):51–9. Gámez AB, Hernandez Morante JJ, Martínez Gil JL, Esparza F, Martínez CM. The effect of surface electromyography biofeedback on the activity of extensor and dorsiflexor muscles in elderly adults: a randomized trial. Sci Rep. 2019 Sep;9(1):13153. González N, Bilbao A, Forjaz MJ, Ayala A, Orive M, Garcia-Gutierrez S, et al. Psychometric characteristics of the Spanish version of the Barthel Index. Aging Clin Exp Res. 2018 May;30(5):489–97. See J, Dodakian L, Chou C, Chan V, McKenzie A, Reinkensmeyer DJ, et al. A standardized approach to the Fugl-Meyer assessment and its implications for clinical trials. Neurorehabil Neural Repair. 2013;27(8):732–41. Kim MK, Ji SG, Cha HG. The effect of mirror therapy on balance ability of subacute stroke patients. Hong Kong Physiother J. 2016 Jun;34:27–32. Brunetti M, Morkisch N, Fritzsch C, Mehnert J, Steinbrink J, Niedeggen M, et al. Potential determinants of efficacy of mirror therapy in stroke patients: a pilot study. Restor Neurol Neurosci. 2015 Aug;33(4):421–34. Blanco-Alonso M, Da Cuña-Carrera I, González-González Y. Efectividad de la terapia en espejo en la rehabilitación del ictus effectiveness of mirror therapy in stroke rehabilitation. Arch Neurocienc. 2020;24:48–59. Prabhakaran S, Zarahn E, Riley C, Speizer A, Chong JY, Lazar RM, et al. Inter-individual variability in the capacity for motor recovery after ischemic stroke. Neurorehabil Neural Repair. 2008 Jan;22(1):64–71. Luo Z, Zhou Y, He H, Lin S, Zhu R, Liu Z, et al. Synergistic effect of combined mirror therapy on upper extremity in patients with stroke: a systematic review and meta-analysis. Front Neurol. 2020 Apr;11:155. Franck JA, Smeets RJEM, Seelen HAM. Changes in actual arm-hand use in stroke patients during and after clinical rehabilitation involving a well-defined arm-hand rehabilitation program: a prospective cohort study. PLoS One. 2019 Apr;14(4):e0214651. Kong Q, Ma X, Wang C, Feng W, Ovbiagele B, Zhang Y, et al. Influence of age ranges on relationship of complex aortic plaque with cervicocephalic atherosclerosis in ischemic stroke. J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1586–96. Povroznik JM, Ozga JE, Vonder Haar C, Engler-Chiurazzi EB. Executive (dys)function after stroke: special considerations for behavioral pharmacology. Behav Pharmacol. 2018 Oct;29(7):638–53. Valkenborghs SR, Vliet P, Nilsson M, Zalewska K, Visser MM, Erickson KI, et al. Aerobic exercise and consecutive task-specific training (AExaCTT) for upper limb recovery after stroke: a randomized controlled pilot study. Physiother Res Int. 2019 Jul;24:e1775. Granger CV, Albrecht GL, Hamilton BB. Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel Index. Arch Phys Med Rehabil. 1979 Apr;60(4):145–54. Arya KN. Underlying neural mechanisms of mirror therapy: implications for motor rehabilitation in stroke. Neurol India. 2016 Jan;64(1):38. Hamzei F, Läppchen CH, Glauche V, Mader I, Rijntjes M, Weiller C. Functional plasticity induced by mirror training: the mirror as the element connecting both hands to one hemisphere. Neurorehabil Neural Repair. 2012 Jun;26(5):484–96. Wang J, Fritzsch C, Bernarding J, Holtze S, Mauritz KH, Brunetti M, et al. A comparison of neural mechanisms in mirror therapy and movement observation therapy. J Rehabil Med. 2013;45(4):410–3. Kang YJ, Ku J, Kim HJ, Park HK. Facilitation of corticospinal excitability according to motor imagery and mirror therapy in healthy subjects and stroke patients. Ann Rehabil Med. 2011;35(6):747. Furukawa K, Suzuki H, Fukuda J. Motion of the drawing hand induces a progressive increase in muscle activity of the non-dominant hand in Ramachandran’s mirror-box therapy. J Rehabil Med. 2012;44(11):939–43. Hiragami S, Inoue Y, Harada K. Minimal clinically important difference for the Fugl-Meyer assessment of the upper extremity in convalescent stroke patients with moderate to severe hemiparesis. J Phys Ther Sci. 2019;31(11):917–21. Roman N, Miclaus R, Repanovici A, Nicolau C. Equal opportunities for stroke survivors’ rehabilitation: a study on the validity of the upper extremity Fugl-Meyer assessment scale translated and adapted into Romanian. Medicina. 2020 Aug;56(8):409. Article / Publication Details

First-Page Preview

Received: October 18, 2021
Accepted: January 30, 2022
Published online: April 04, 2022

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 1

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: https://www.karger.com/ENE

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.