title: Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial.
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.
  
  
  METHODS
  This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes, MT improves neglect.
authors.affiliation: 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.
authors.forename: Jeyaraj D
authors.initials: JD
authors.lastname: Pandian
authors.affiliation: 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.
authors.forename: Rajni
authors.initials: R
authors.lastname: Arora
authors.affiliation: 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.
authors.forename: Paramdeep
authors.initials: P
authors.lastname: Kaur
authors.affiliation: 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.
authors.forename: Deepika
authors.initials: D
authors.lastname: Sharma
authors.affiliation: 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.
authors.forename: Dheeraj K
authors.initials: DK
authors.lastname: Vishwambaran
authors.affiliation: 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.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D055096:Optical Devices; D009903:Optical Illusions; D010296:Parietal Lobe / Q000473:pathology; D010468:Perceptual Disorders / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000473:pathology; D013788:Thalamus / Q000473:pathology; D016896:Treatment Outcome
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