title: Mirror therapy for improving motor function after stroke.
abstract: OBJECTIVE
  This systematic review summarizes the effectiveness of mirror therapy for improving motor function, activities of daily living, pain, and visuospatial neglect in patients after stroke.
  
  
  METHODS
  We searched the Cochrane Stroke Group’s Trials Register (June 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), MEDLINE (1950 to June 2011), EMBASE (1980 to June 2011), CINAHL (1982 to June 2011), AMED (1985 to June 2011), PsycINFO (1806 to June 2011), and PEDro (June 2011). We also handsearched relevant conference proceedings, trials, and research registers; checked reference lists; and contacted trialists, researchers, and experts in our field of study. We included randomized controlled trials and randomized crossover trials comparing mirror therapy with any control intervention for patients after stroke. Two review authors independently selected trials based on the inclusion criteria, documented the methodological quality of studies, and extracted data. The primary outcome was motor function. We analyzed the results as standardized mean differences (SMDs) for continuous variables.
  
  
  RESULTS
  We included 14 studies with a total of 567 participants, which compared mirror therapy with other interventions. When compared with all other interventions, mirror therapy was found to have a significant effect on motor function (postintervention data: SMD 0.61; 95% CI 0.22 to 1.0; P=0.002; change scores: SMD 1.04; 95% CI 0.57 to 1.51; P<0.0001) ; Figure). However, effects on motor function are influenced by the type of control intervention. Additionally, mirror therapy was found to improve activities of daily living (SMD 0.33; 95% CI 0.05 to 0.60; P=0.02). We found a significant positive effect on pain (SMD −1.10; 95% CI −2.10 to −0.09; P=0.03), which is influenced by patient population. We found limited evidence for improving visuospatial neglect (SMD 1.22; 95% CI 0.24 to 2.19; P=0.01). The effects on motor function were stable at follow-up assessment after 6 months.
authors: Holm
authors: H
authors: Thieme
authors: Jan
authors: J
authors: Mehrholz
authors: Marcus
authors: M
authors: Pohl
authors: Johann
authors: J
authors: Behrens
authors: Christian
authors: C
authors: Dohle
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D006801:Humans; D009048:Motor Skills / Q000502:physiology; D010468:Perceptual Disorders / Q000503:physiopathology / Q000628:therapy; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*