Effects of mirror therapy on upper limb motor function of patients with stroke: A systematic review and meta-analysis of randomized controlled trials.

IF 2.6 3区医学 Q1 REHABILITATION Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2025-01-21 DOI:10.1177/02692155241299211

Ita Daryanti Saragih, Ratna Puji Priyanti, Sakti Oktaria Batubara, Bih-O Lee

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Abstract

Objectives: This study aimed to investigate and review the effects of mirror therapy on upper limb function, including improvements in shoulder, elbow, forearm, wrist, and hand function, as well as coordination between the upper extremities, in patients with stroke.

Data sources: Six databases, CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Embase, Medline Complete, PubMed, and Web of Science, were searched from database inception to 15 October 2024, as well as manual searching of Google Scholar, for relevant trials.

Review methods: The methodological quality of the trials was assessed using version 2 of the Cochrane risk-of-bias tool with five domains. A random-effects model was applied to calculate the pooled mean difference of dichotomous variables using the 95% confidence interval. The variance in effect estimation in a forest plot for each trial was then quantified using I².

Results: Eighteen studies, representing 633 patients with stroke, were included in this study. Mirror therapy significantly improved upper limb motor function (mean difference [MD] = 1.79; 95% CI = 0.04-3.54; p = 0.04) and hand function (MD = 1.48; 95% CI = 0.17-2.78; p = 0.03) in patients with stroke. Subgroup analyses of overall upper limb function showed that mirror therapy was effective in improving function when delivered more than 5 times a week (MD = 2.75; 95% CI = 1.02-4.48) over a period of ≤ 4 weeks (MD = 3.26; 95% CI = 1.19-5.33). The results of the methodology assessment using RoB-2 on all the trials included in the analysis showed that 16 trials were considered to have some concerns.

Conclusion: Mirror therapy appears to be beneficial for improving upper limb motor function after stroke. More trials are needed to determine the effects of mirror therapy on shoulder/elbow/forearm, wrist, and hand function and coordination between upper extremities after stroke.

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镜像疗法对中风患者上肢运动功能的影响：随机对照试验的系统回顾和荟萃分析。

目的：本研究旨在调查和回顾镜像疗法对中风患者上肢功能的影响，包括改善肩、肘、前臂、手腕和手部功能，以及上肢之间的协调。数据来源：检索了从数据库建立到2024年10月15日的6个数据库：CINAHL Plus全文数据库、Cochrane Central Register of Controlled Trials数据库、Embase数据库、Medline Complete数据库、PubMed数据库和Web of Science数据库，以及人工检索谷歌Scholar数据库中相关试验的数据。回顾方法：使用Cochrane风险偏倚工具的第2版（5个领域）评估试验的方法学质量。采用随机效应模型，采用95%置信区间计算二分类变量的混合均值差。然后使用I2对每个试验的森林样地的效应估计方差进行量化。结果：18项研究，633例脑卒中患者纳入本研究。镜像治疗显著改善上肢运动功能(平均差值[MD] = 1.79；95% ci = 0.04-3.54；p = 0.04)和手功能(MD = 1.48；95% ci = 0.17-2.78；P = 0.03)。整体上肢功能的亚组分析显示，每周给予5次以上镜像治疗可有效改善功能(MD = 2.75；95% CI = 1.02-4.48)，时间≤4周(MD = 3.26；95% ci = 1.19-5.33)。使用rob2对纳入分析的所有试验进行方法学评估的结果显示，有16项试验被认为存在一些问题。结论：镜像疗法可改善脑卒中后上肢运动功能。需要更多的试验来确定镜像疗法对中风后肩/肘/前臂、手腕和手部功能和上肢协调的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Rehabilitation 医学-康复医学

CiteScore

5.60

自引率

6.70%

发文量

117

审稿时长

4-8 weeks

期刊介绍： Clinical Rehabilitation covering the whole field of disability and rehabilitation, this peer-reviewed journal publishes research and discussion articles and acts as a forum for the international dissemination and exchange of information amongst the large number of professionals involved in rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE)