title: Mirror therapy in children with hemiparesis: a randomized observer-blinded trial.
abstract: OBJECTIVE
  To determine the efficacy of mirror therapy in children with hemiparesis.
  
  
  METHODS
  The design was an observer-blinded parallel-group randomized controlled trial (International Standard Randomised Controlled Trial Number 48748291). Randomization was computer-generated, 1:1 allocation to mirror therapy or comparison groups. The settings were home-based intervention and tertiary centre assessments. Participants were 90 children with hemiparesis aged 7 to 17 years. Intervention was 15 minutes per day of simultaneous arm training, 5 days a week, for 5 weeks. The mirror therapy group used a mirror; those in the comparison group looked at their paretic limb. Assessments comprised measures of upper limb strength, function (Melbourne Assessment 2), daily performance (ABILHAND-Kids), and sensory function at weeks 0 (T0 ), 5 (T1 ), and 10 (T2 ).
  
  
  RESULTS
  There were no significant differences in outcomes and their progression over time between the mirror therapy and comparison groups. Post-hoc intention-to-treat analyses showed significant improvements in both groups for grasp strength (T0 -T1 +12.6%), pinch strength (T0 -T2 +9.1%), upper limb function in terms of accuracy (T0 -T2 +2.7%) and fluency (T0 -T2 +5.0%), as well as daily performance (T0 -T2 +16.6%). Per protocol analyses showed additional improvements in dexterity (T0 -T2 +4.0%).
  
  
  CONCLUSIONS
  The use of the mirror illusion during therapy had no significant effect on treatment outcomes. However, 5 weeks of daily simultaneous arm training significantly improved paretic upper limb strength, function, and daily use.
authors.affiliation: Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Roselyn
authors.initials: R
authors.lastname: Bruchez
authors.affiliation: Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Marine
authors.initials: M
authors.lastname: Jequier Gygax
authors.affiliation: Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Roches
authors.affiliation: Paediatric Neurology, Paediatric Subspecialities Service, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Joel
authors.initials: J
authors.lastname: Fluss
authors.affiliation: Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Jacquier
authors.affiliation: Clinical Research Centre, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Ballabeni
authors.affiliation: Child Rehabilitation Unit, Bern University Hospital, Bern, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Grunt
authors.affiliation: Paediatric Neurology and Neurorehabilitation Unit, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Christopher J
authors.identifier: http://orcid.org/0000-0002-9874-6681
authors.initials: CJ
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D002648:Child; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007088:Illusions / Q000502:physiology*; D033182:Intention; D008297:Male; D010291:Paresis / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D016037:Single-Blind Method; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology