Effect of Mirror Therapy on Unilateral Neglect for Patients After Stroke

Effect of Mirror Therapy on Unilateral Neglect for Patients After Stroke

This is a single-blinded randomized controlled trial to investigate the effects of mirror therapy (MT), with reference to sham mirror (a glass wall) and control (a covered mirror), in reducing unilateral neglect for patients with stroke in 2 centres.

Twenty-one subacute inpatients with left unilateral neglect after right-hemispheric stroke, recruited from 2 hospitals - Hong Kong and Guangzhou, in 1 and a half years, were randomly assigned to three groups; mirror therapy, sham therapy (in the form of a transparent glass wall), and control (covered mirror). The treatment programme for all groups consisted of 12 sessions (4 per week for 3 weeks) movement practice for the hemiplegic arm involved 5 table-top tasks graded according to the severity of patients' arm impairments. Blinded assessments were administered at baseline, 3-week postintervention, and 3-week follow-up upon completion of training.

Inclusion Criteria:

• ischemic or hemorrhagic stroke, confirmed by medical diagnoses compatible with a unilateral right lesion involvement (i.e. left hemiplegic), exhibited left visual field inattention or unilateral neglect by obtaining a total score of star cancellation subtest in the conventional battery of the Behavioural Inattention Test ≤ 51 (out of 54);
• stroke with onset of neurological condition ≤ 6 months previously;
• have normal or corrected-to-normal visual acuity better than 20/60 (6/18) in the better eye;
• with hemiplegic upper extremity functional levels 3-7 as rated by Functional Test for the Hemiplegic Upper Extremity and is able to move against gravity;
• ability to understand and follow simple verbal instructions, with Mini-mental State Examination ≥ 21;
• ability to participate in a therapy session lasting at least 30 minutes;
• consent to participant in the study

Exclusion Criteria:

• prior neurological or psychiatric disorders;
• severe spasticity (Modified Ashworth Scale >3) over paretic arm;
• history of recent Botox injection or acupuncture to the paretic arm within the past three months;
• participation in another clinical study elsewhere apart from the study site during recruitment