Objective To observe the effects of mirror therapy (MT) combined with functional electrical stimulation (FES) on motor of lower extremities, walking ability and activities of daily living for subacute stroke patients. Methods From July, 2016 to December, 2017, 38 subacute stroke patients were randomly divided into treatment group (n=20) and control group (n=18). All the patients received routine rehabilitation. The control group accepted FES, and the treatment group accepted FES and MT, for eight weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Categories (FAC) and modified Barthel Index (MBI) before and after treatment. Results Both groups improved in the scores of FMA-LE and MBI, and grade of FAC after treatment (Z>3.002, t>7.985, P<0.01), and the scores of FMA-LE improved more in the treatment group than in the control group (Z=-2.037, P<0.05). There was no difference between two groups in the scores of MBI and grade of FAC (t=-1.044, Z=-1.287, P>0.05). Conclusion The addition of MT on FES may further improve the lower extremities motor function, but not enough to improve their walking and activities of daily living in subacute stroke patients.
XU Le-yi
,
ZHOU Ying
,
LIU Mei-kuai
,
LIN Ling
,
CHEN Qi-qi
,
LI Hai-yan
. Effects of Mirror Therapy on Motor Function of Lower Extremities and Walking in Subacute Stroke Patients[J]. Chinese Journal of Rehabilitation Theory and Practice, 2018
, 24(7)
: 834
-838
.
DOI: 10.3969/j.issn.1006-9771.2018.07.015
[1] Bonita R, Mendis S, Truelsen T, et al.The global stroke initiative[J]. Lancet Neurol, 2004, 3(7): 391-393.
[2] 中华医学会神经病学分会. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4): 246-257.
[3] 陈昱,陈月桂,燕铁斌. 基于行走模式的功能性电刺激对健康青年体感诱发电位的影响[J]. 中华物理医学与康复杂志, 2011, 33(6): 431-434.
[4] 沈芳,王晶,曾明. 镜像疗法在脑卒中偏瘫患者上肢运动功能康复中应用的研究进展[J]. 中国康复医学杂志, 2016, 31(5): 590-593.
[5] Kim H, Lee G, Song C.Effect of functional electrical stimulation with mirror therapy on upper extremity motor function in poststroke patients[J]. J Stroke Cerebrovasc Dis, 2014, 23(4): 655-661.
[6] 李梦晓,冯丽娟,张福蓉,等. 镜像视觉反馈疗法在康复训练中的研究进展[J]. 中国康复理论与实践, 2017, 23(12): 1403-1406.
[7] 中华神经外科杂志. 脑血管疾病分类(1995年)[J]. 中华神经外科杂志, 1997, 13(1): 5-6.
[8] 单莎瑞,黄国志,曾庆,等. 步态诱发功能性电刺激对脑卒中后足下垂患者步态时空参数的影响[J]. 中国康复医学杂志, 2013, 28(6): 558-563.
[9] 金冬梅,庄志强,燕铁斌,等. 功能性电刺激治疗对急性脑梗死大鼠运动功能和缺血半影区微管相关蛋白-2表达的影响[J]. 中国康复医学杂志, 2009, 24(6): 505-508.
[10] 许佳,胡世红,凌晴,等. 功能性电刺激对偏瘫患者下肢功能及步态的影响[J]. 中国康复, 2015, 30(3): 189-191.
[11] Ramachandran VS, Rogersramachandran D.Synaesthesia in phantom limbs induced with mirrors[J]. Proc Biol Sci, 1996, 263(1369): 377-386.
[12] Sutbeyaz S, Yavuzer G, Sezer N, et al.Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2007, 88(5): 555-559.
[13] Mohan U, Babu SK, Kumar KV, et al.Effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke: a randomized sham-controlled pilot trial[J]. Ann Indian Acad Neurol, 2013, 16(4): 634-639.
[14] Arya KN, Pandian S, Kumar V.Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke: a randomised controlled trial[J]. Neuropsychol Rehabil, 2017, 26(9): 1-18.
[15] Collins JJ, de Luca CJ. The effects of visual input on open-loop and closed-loop postural control mechanisms[J]. Exp Brain Res, 1995, 103(1): 151-163.
[16] Patla A.How is human gait controlled by vision?[J]. Ecol Psychol, 1988, 10(34): 287-302.
[17] Yavuzer G, Selles R, Sezer N, et al.Mirror therapy improves hand function in subacute stroke: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2008, 89(3): 393-398.
[18] Schabrun SM, Hillier S.Evidence for the retraining of sensation after stroke: a systematic review[J]. Clin Rehabil, 2009, 23(1): 27-39.
[19] Guo F, Xu Q, Abo Salem HM, et al.The neuronal correlates of mirror therapy: a functional magnetic resonance imaging study on mirror-induced visual illusions of ankle movements[J]. Brain Res, 2016, 16(39): 186-193.
[20] Saleh S, Adamovich SV, Tunik E.Mirrored feedback in chronic stroke: recruitment and effective connectivity of ipsilesional sensorimotor networks[J]. Neurorehabil Neural Repair, 2014, 28(4): 344-354.
[21] Luft AR, McCombe-Waller S, Whitall J, et al. Repetitive bilateral arm training and motor cortex activation in chronic stroke: a randomized controlled trial[J]. JAMA, 2004, 292(15): 1853-1861.
[22] Cauraugh JH, Summers JJ.Neural plasticity and bilateral movements: a rehabilitation approach for chronic stroke[J]. Prog Neurobiol, 2005, 75(5): 309-320.
[23] Crosby LD, Marrocco S, Brown J, et al.A novel bilateral lower extremity mirror therapy intervention for individuals with stroke[J]. Heliyon, 2016, 2(12): e00208.
[24] Lee D, Lee G, Jeong J.Mirror therapy with neuromuscular electrical stimulation for improving motor function of stroke survivors: a pilot randomized clinical study[J]. Technol Health Care, 2016, 24(4): 503-511.
[25] Salhab G, Sarraj AR, Saleh S.Mirror therapy combined with functional electrical stimulation for rehabilitation of stroke survivors' ankle dorsiflexion[J]. Conf Proc IEEE Eng Med Biol Soc, 2016, 2016(38): 4699-4702.
