镜像疗法对脑卒中患者下肢运动、平衡功能和步行能力效果的Meta分析

doi:10.3969/j.issn.1006-9771.2020.09.004

Abstract

Abstract:

Objective To evaluate the effect of mirror therapy on lower-limb motor, balance and walking of stroke patients.
Methods Randomized controlled trails (RCTs) about mirror therapy for lower limb function after stroke were recalled in PubMed, Cochrane Library, EMbase, Medline complete, CNKI, Wanfang Data, VIP and CBMdisc. Meta-analysis was conducted using RevMan 5.3 software for eligible RCTs.
Results A total of twelve studies were retrieved, including 590 patients. Mirror therapy improved the scores of Fugl-Meyer Assessment-Lower Extremity (MD = 6.67, 95%CI 5.60 to 7.74; Z = 12.20, P< 0.001), Brunnstrom stages (MD = 0.55, 95%CI 0.28 to 0.82;Z = 3.98, P< 0.001), Berg Balance Scale (MD = 3.45, 95%CI 1.40 to 5.50;Z = 3.30, P = 0.001), mini-BESTest (MD = 1.49, 95%CI 0.65 to 2.33; Z = 3.48, P< 0.001), Brunnel Balance Assessment (MD = 0.66, 95%CI 0.10 to 1.22;Z = 2.32, P = 0.02). However, it was not significant for 10-meter Walking Test (MD = 0.03, 95%CI -0.04 to 0.11; Z = 0.88, P = 0.38) and Timed "Up and Go" Test (MD = -1.43, 95%CI -4.31 to 1.45; Z = 0.97, P = 0.33).
Conclusion Mirror therapy can improve lower extremity motor function after stroke significantly, and somehow for balance. Further research is needed to explore its effects on walking.

Key words: stroke, mirror therapy, lower limbs, motor, balance, walking, meta-analysis

WU Jing-hua,WU Ju-fen,KUANG Dan,YU Hui,HUA Jiao. Effects of Mirror Therapy on Lower-limb Motor, Balance and Walking after Stroke: A Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(9): 1015-1023.

Figures/Tables 14

纳入研究	国家	n		年龄(岁)		病程		病情	干预措施		干预时间	结局指标
纳入研究	国家	C	T	C	T	C	T	病情	C	T	干预时间	结局指标
陈其强等2019^[8]	中国	55	55	53.90±2.70	53.30±3.10	< 8周	< 8周	Brunnstrom Ⅰ~Ⅳ期	传统治疗	传统治疗+运动为基础镜像疗法	30 min/次,5次/周,共8周	①④
Arya等2019^[9]	印度	17	19	44.53±6.09	48.16±8.36	(18.29±8.08)个月	(13.74±9.45) 个月	Brunnstrom ≥ Ⅱ期	传统治疗	传统治疗+任务为基础镜像疗法	60 min/次,3~4次/周,共12周	①⑥
黎伟雄等2018^[10]	中国	30	30	54.60±9.20	52.90±9.90	(6.70±2.30) d	(7.10±3.40) d	Brunnstrom ≥ Ⅲ期	传统治疗+假镜像疗法(无镜像)	传统治疗+运动为基础镜像疗法	30 min/次,5次/周,共8周	①③
Xu等2017^[11]	中国	23	23	56.09±8.12	53.70±8.98	(45.78±6.50) d	(42.76±5.65) d	Brunnstrom Ⅰ~Ⅳ期	传统治疗+假镜像疗法(无镜像)	传统治疗+运动为基础镜像疗法	30 min/次,5次/周,共4周	②⑥
王海燕等2017^[12]	中国	62	62	53.19±6.02	51.86±5.63	(4.13±1.06) 个月	(3.91±0.78) 个月	Brunnstrom ≥ Ⅲ期	传统治疗	传统治疗+运动为基础镜像疗法	15 min/次,6次/周,共8周	①④
In等2016^[13]	韩国	12	13	54.42±11.44	57.31±10.53	(13.58±5.28) 个月	(12.54±4.14) 个月	Brunnstrom Ⅰ~Ⅳ期	传统治疗+假镜像疗法(无镜像)	传统治疗+运动和任务为基础镜像疗法	60 min/次,5次/周,共4周	③⑥⑦
Kim等2016^[14]	韩国	17	17	54.60±10.20	52.40 ±7.20	(4.50±1.10) 个月	(4.70±1.30) 个月	Ashworth量表 < Ⅲ 期	传统治疗+假镜像疗法(无镜像)	传统治疗+运动为基础镜像疗法	60 min/次,5次/周,共4周	⑤
Lee等2016^[15]	韩国	13	14	53.62±6.29	55.71±6.70	(42.54±33.90)个月	(36.79±26.07)个月	Brunnstrom Ⅰ~Ⅳ期	传统治疗	传统治疗+运动为基础镜像疗法	60 min/次,5次/周,共4周	③⑥⑦
Salem等 2015^[16]	埃及	15	15	59.10±9.10	60.00±8.97	(15.40±1.28)个月	(14.90±1.83)个月	Brunnstrom Ⅰ~Ⅳ 期	假镜像疗法(无镜像)	运动为基础镜像疗法	30 min/次,5次/周,共4周	②⑥
Cha等 2015^[17]	韩国	17	19	57.35±9.38	60.00±7.80	(1.65±0.86) 个月	(1.95±0.62) 个月	Brunnstrom Ⅰ~Ⅳ期	传统治疗+假镜像疗法(无镜像)	传统治疗+运动为基础镜像疗法	40 min/次,5次/周,共4周	③⑦
Mohan等2013^[18]	印度	11	11	59.80±6.70	62.64±17.30	(5.73±3.47) 个月	(7.09±3.18) 个月	Brunnstrom Ⅰ~Ⅴ期	假镜像疗法(无镜像)	运动为基础镜像疗法	30 min/次,5次/周,共4周	①⑤
Sütbeyaz等 2007^[19]	荷兰	20	20	64.70±7.70	62.70±9.70	(3.90±1.90) 个月	(3.50±1.30) 个月	Brunnstrom Ⅰ~Ⅲ期	假镜像疗法(无镜像)	运动为基础镜像疗法	30 min/次,5次/周,共4周	②

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纳入研究	随机序列产生	分配隐藏	对实施者及参与者实施盲法	对结果测评者实施盲法	数据结果的完整性	选择性报告研究结果	其他偏倚来源	证据质量
陈其强等2019^[8]	低偏倚	不清楚	低偏倚	不清楚	低偏倚	低偏倚	不清楚	B
Arya等2019^[9]	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	A
黎伟雄等2018^[10]	低偏倚	不清楚	低偏倚	不清楚	低偏倚	低偏倚	不清楚	B
Xu等2017^[11]	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	A
王海燕等2017^[12]	低偏倚	不清楚	低偏倚	不清楚	低偏倚	低偏倚	不清楚	B
In等2016^[13]	低偏倚	不清楚	高偏倚	低偏倚	低偏倚	不清楚	不清楚	B
Kim等2016^[14]	低偏倚	低偏倚	不清楚	低偏倚	低偏倚	低偏倚	不清楚	B
Lee等2016^[15]	低偏倚	不清楚	不清楚	低偏倚	低偏倚	低偏倚	不清楚	B
Salem等2015^[16]	低偏倚	不清楚	高偏倚	低偏倚	低偏倚	不清楚	不清楚	B
Cha等2015^[17]	低偏倚	低偏倚	高偏倚	低偏倚	不清楚	低偏倚	不清楚	B
Mohan等2013^[18]	低偏倚	不清楚	低偏倚	低偏倚	低偏倚	不清楚	不清楚	B
Sütbeyaz等2007^[19]	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	低偏倚	A

Effects of Mirror Therapy on Lower-limb Motor, Balance and Walking after Stroke: A Meta-analysis

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