title: Combining afferent stimulation and mirror therapy for rehabilitating motor function, motor control, ambulation, and daily functions after stroke.
abstract: BACKGROUND
  Mirror therapy (MT) and mesh glove (MG) afferent stimulation may be effective in reducing motor impairment after stroke. A hybrid intervention of MT combined with MG (MT + MG) may broaden aspects of treatment benefits.
  
  
  OBJECTIVE
  To demonstrate the comparative effects of MG + MT, MT, and a control treatment (CT) on the outcomes of motor impairments, manual dexterity, ambulation function, motor control, and daily function.
  
  
  METHODS
  Forty-three chronic stroke patients with mild to moderate upper extremity impairment were randomly assigned to receive MT + MG, MT, or CT for 1.5 hours/day, 5 days/week for 4 weeks. Outcome measures were the Fugl-Meyer Assessment (FMA) and muscle tone measured by Myoton-3 for motor impairment and the Box and Block Test (BBT) and 10-Meter Walk Test (10 MWT) for motor function. Secondary outcomes included kinematic parameters for motor control and the Motor Activity Log and ABILHAND Questionnaire for daily function.
  
  
  RESULTS
  FMA total scores were significantly higher and synergistic shoulder abduction during reach was less in the MT + MG and MT groups compared with the CT group. Performance on the BBT and the 10 MWT (velocity and stride length in self-paced task and velocity in as-quickly-as-possible task) were improved after MT + MG compared with MT.
  
  
  CONCLUSIONS
  MT + MG improved manual dexterity and ambulation. MT + MG and MT reduced motor impairment and synergistic shoulder abduction more than CT. Future studies may integrate functional task practice into treatments to enhance functional outcomes in patients with various levels of motor severity. The long-term effects of MG + MT remain to be evaluated.
authors.affiliation: 1National Taiwan University, Taipei, Taiwan.
authors.forename: Keh-chung
authors.initials: KC
authors.lastname: Lin
authors.forename: Pai-chuan
authors.initials: PC
authors.lastname: Huang
authors.forename: Yu-ting
authors.initials: YT
authors.lastname: Chen
authors.forename: Ching-yi
authors.initials: CY
authors.lastname: Wu
authors.forename: Wen-ling
authors.initials: WL
authors.lastname: Huang
mesh_terms: D000203:Activities of Daily Living; D002908:Chronic Disease / Q000628:therapy; D003131:Combined Modality Therapy; D004558:Electric Stimulation; D056228:Feedback, Sensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000534:rehabilitation*; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D017833:Visceral Afferents / Q000502:physiology
keywords: activities of daily living; electrical stimulation; kinematics; mirror therapy; stroke rehabilitation