Jeyaraj D Pandian1, Rajni Arora2, Paramdeep Kaur2, Deepika Sharma2, Dheeraj K Vishwambaran2, Hisatomi Arima2. 1. From the Stroke Unit, Department of Neurology (J.D.P., R.A., P.K., D.S.) and College of Physiotherapy (D.K.V.), Christian Medical College, Ludhiana, Punjab, India; and The George Institute for Global Health (H.A.), University of Sydney, Australia. jeyarajpandian@hotmail.com. 2. From the Stroke Unit, Department of Neurology (J.D.P., R.A., P.K., D.S.) and College of Physiotherapy (D.K.V.), Christian Medical College, Ludhiana, Punjab, India; and The George Institute for Global Health (H.A.), University of Sydney, Australia.
Abstract
OBJECTIVE: We explored the effectiveness of mirror therapy (MT) in the treatment of unilateral neglect in stroke patients. METHODS: This is an open, blinded endpoint, randomized controlled trial carried out from January 2011 to August 2013. We included stroke patients with thalamic and parietal lobe lesions with unilateral neglect 48 hours after stroke. Patients were randomized to the MT group or the control group (sham MT), and both the groups received limb activation. Patients received treatment for 1-2 hours a day 5 days a week for 4 weeks. The primary outcome was unilateral neglect assessed by a blinded assessor using the star cancellation test, the line bisection test, and a picture identification task at 1, 3, and 6 months. This study was registered at http://clinicaltrials.gov (NCT 01735877). RESULTS:Forty-eight patients were randomized to MT (n = 27) or the control group (n = 21). Improvement in scores on the star cancellation test over 6 months was greater in the MT group (mean difference 23, 95% confidence interval [CI] 19-28; p < 0.0001). Similarly, improvement in the MT group was observed in the scores on the picture identification task (mean difference 3.2, 95% CI 2.4-4.0; p < 0.0001) and line bisection test (mean difference 8.6, 95% CI 2.7-14.6; p = 0.006). CONCLUSIONS: In patients with stroke, MT is a simple treatment that improves unilateral neglect. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes, MT improves neglect.
RCT Entities:
OBJECTIVE: We explored the effectiveness of mirror therapy (MT) in the treatment of unilateral neglect in strokepatients. METHODS: This is an open, blinded endpoint, randomized controlled trial carried out from January 2011 to August 2013. We included strokepatients with thalamic and parietal lobe lesions with unilateral neglect 48 hours after stroke. Patients were randomized to the MT group or the control group (sham MT), and both the groups received limb activation. Patients received treatment for 1-2 hours a day 5 days a week for 4 weeks. The primary outcome was unilateral neglect assessed by a blinded assessor using the star cancellation test, the line bisection test, and a picture identification task at 1, 3, and 6 months. This study was registered at http://clinicaltrials.gov (NCT 01735877). RESULTS: Forty-eight patients were randomized to MT (n = 27) or the control group (n = 21). Improvement in scores on the star cancellation test over 6 months was greater in the MT group (mean difference 23, 95% confidence interval [CI] 19-28; p < 0.0001). Similarly, improvement in the MT group was observed in the scores on the picture identification task (mean difference 3.2, 95% CI 2.4-4.0; p < 0.0001) and line bisection test (mean difference 8.6, 95% CI 2.7-14.6; p = 0.006). CONCLUSIONS: In patients with stroke, MT is a simple treatment that improves unilateral neglect. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes, MT improves neglect.
Authors: Holm Thieme; Nadine Morkisch; Jan Mehrholz; Marcus Pohl; Johann Behrens; Bernhard Borgetto; Christian Dohle Journal: Cochrane Database Syst Rev Date: 2018-07-11