Title: Scenario 1, Mirror therapy in patients post stroke

Part 1 : Summary

Ramachandran and colleagues developed mirror therapy to treat amputees’ agony from phantom limbs. Patients were able to feel their amputated limb without experiencing any pain by presenting them a mirror image of their healthy arm. Since then, studies on the mirror therapy paradigm have also been conducted in additional pain- and motor-related diseases, including stroke and hand surgery, as well as chronic regional pain syndrome. Mirror treatment may considerably enhance upper limb motor function in stroke patients, even if the included trials had high levels of heterogeneity, according to some evidence from meta-analysis (Wen et al., 2022).

Unlike other types of therapy, mirror therapy (MT) employs visual cues to elicit a desired reaction in the damaged limb, allowing it to be utilised with stroke survivors who are entirely paralysed. After a stroke, MT has been shown to have effects on sensations, neglect of visuospatial information, and discomfort. Although the level of improvements in sensory deficits and hemineglect are limited, MT exhibited undeniable improvements in motor and sensory function. Although its long-term consequences and effects on performing everyday tasks daily living need to be thoroughly examined, MT demonstrates to be a successful and practical technique to rehabilitating post-stroke individuals in the acute, subacute, and chronic phases of stroke (Gandhi et al., 2020).

Several studies have reported about the positive effects of mirror therapy (MT) on the post stroke treatment in several patients. For instance, one of the studies examined the neural correlates of the mirror-induced visual illusion in stroke patients in an effort to better understand how mirror treatment functions. It has been demonstrated that mirror therapy enhanced activity during bimanual movement as a result of the mirror illusion in two areas; the precuneus and the posterior cingulate cortex, to our knowledge, in which stroke patients with stroke participated instead of healthy volunteers. It has also been reported that no indication has been found in the mirror illusion increased activity in motor regions or the MNS, nor did it was uncovering any evidence of a differential effect of the mirror illusion on neuronal activity during unimanual movement (Wen et al., 2022).

In order to evaluate how well mirror therapy works for restoring motor function and motor impairment following a stroke, it will be compared to other treatments, no treatment, placebo or sham therapy, and other treatments. Aside from everyday living activities, discomfort, and visuospatial neglect, we also wanted to evaluate how mirror treatment affected those areas. Five randomised cross-over trials and 57 randomised controlled trials out of these were conducted. The participants’ ages ranged from 30 to 73 years, with a mean age of 59. For two to eight weeks, mirror therapy sessions were held three to seven times a week, lasting between 15 and 60 minutes each (on average, five sessions each week lasted 30 minutes). It is also discovered moderate-quality evidence mirror treatment significantly improves motor function when compared to all other interventions (Thieme et al., 2018).

Numerous rehabilitation programmes, such as constraint-induced movement, motor re-learning, electromyographic biofeedback, and robot-assisted therapy, have been examined with the goal of promoting motor function of the afflicted upper extremity in stroke patients. Standard multidisciplinary rehabilitation programmes for stroke victims are difficult, labor-intensive, and expensive to implement. Mirror therapy (MT), a straightforward, affordable, and labor-intensive rehabilitation technique, has been suggested as a promising rehabilitation strategy for recovering motor function of the upper limb in stroke patients (Zeng et al., 2018).

Part 2: Reflection

From the analysis of the scenario on mirror therapy in patients post stroke, I have analysed that the biggest cause of illness and mortality in the globe is stroke. It frequently results in partial or complete loss of upper extremity motor function in survivors. More than 50% of stroke survivors have impaired upper extremity motor function, which has a significant negative impact on their quality of life. Clearly, stroke patients need to regain their upper extremity motor function. From the several literature-based studies, I have evaluated that motor therapy was one of the main therapies for the management of stroke symptoms in the patient. I have also analysed that MT is an effective technique for rehabilitating post-stroke deficits in the acute, subacute, and chronic stages (deficits in motor, sensory, and perceptual function). Bilateral arm training enhances the patient’s responsiveness to MT. Mirror therapy (MT), in contrast to other forms of therapy, uses visual cues to elicit a desired response in the injured limb, enabling it to be used with stroke survivors who are completely paralysed. I have concluded that to improve motor function of the affected upper extremity in stroke patients, a variety of rehabilitation programmes, including constraint-induced movement, motor re-learning, electromyographic biofeedback, and robot-assisted therapy, have been investigated.

References Gandhi, D. B., Sterba, A., Khatter, H., & Pandian, J. D. (2020). Mirror Therapy in Stroke Rehabilitation: Current Perspectives. Therapeutics and clinical risk management, 16, 75–85.

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