Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients.
BACKGROUND
Complex regional pain syndrome type 1 (CRPSt1) of the upper limb is a painful and debilitating condition, frequent after stroke, and interferes with the rehabilitative process and outcome. However, treatments used for CRPSt1 of the upper limb are limited.


OBJECTIVE
. This randomized controlled study was conducted to compare the effectiveness on pain and upper limb function of mirror therapy on CRPSt1 of upper limb in patients with acute stroke.


METHODS
. Of 208 patients with first episode of unilateral stroke admitted to the authors' rehabilitation center, 48 patients with CRPSt1 of the affected upper limb were enrolled in a randomized controlled study, with a 6-month follow-up, and assigned to either a mirror therapy group or placebo control group. The primary end points were a reduction in the visual analogue scale score of pain at rest, on movement, and brush-induced tactile allodynia. The secondary end points were improvement in motor function as assessed by the Wolf Motor Function Test and Motor Activity Log.


RESULTS
. The mean scores of both the primary and secondary end points significantly improved in the mirror group (P < .001). No statistically significant improvement was observed in any of the control group values (P > .001). Moreover, statistically significant differences after treatment (P < .001) and at the 6-month follow-up were found between the 2 groups.


CONCLUSIONS
. The results indicate that mirror therapy effectively reduces pain and enhances upper limb motor function in stroke patients with upper limb CRPSt1.
Cacchio
Angelo
A
Department of Physical Medicine and Rehabilitation, "San Salvatore" Hospital of L'Aquila, L'Aquila, Italy. angelo.cacchio@tin.it
De Blasis
Elisabetta
E
De Blasis
Vincenzo
V
Santilli
Valter
V
Spacca
Giorgio
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010147:Pain Measurement; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D012019:Reflex Sympathetic Dystrophy / Q000503:physiopathology / Q000534:rehabilitation*; D012782:Shoulder / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome