The research progress of mirror therapy in stroke rehabilitation_West China Medical Journal

Authors：

HE Sijin ,  ZHOU Jianying , CHEN Xiaoxia , GU Lihua , CHEN Qigang

Rehabilitation Department, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan 650500, P. R. China;

Corresponding author：

ZHOU Jianying, Email: 673183454@qq.com

Keywords：

Mirror therapy; Stroke; Rehabilitation

DOI：

10.7507/1002-0179.201911018

Video：

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Abstract Full text Figures/Tables Video References Cited by

Stroke is characterized by high morbidity, mortality, disability, recurrence rate and economic burden. In addition to secondary prevention after stroke, rehabilitation is one of the most important means for the recovery of post-stroke dysfunction. Traditional rehabilitation methods have limited effect on the recovery of function for patients after stroke. Mirror therapy is a safe and feasible treatment, which is widely used as a rehabilitation method of many diseases. This paper reviews literatures on the application of mirror therapy in stroke rehabilitation (limb dysfunction, unilateral neglect, swallowing disorder and complex regional pain syndrome) at home and abroad, and summarizes it’s potential mechanisms, so as to provide references to future research and application of mirror therapy.

Citation： HE Sijin, ZHOU Jianying, CHEN Xiaoxia, GU Lihua, CHEN Qigang. The research progress of mirror therapy in stroke rehabilitation. West China Medical Journal, 2020, 35(6): 729-733. doi: 10.7507/1002-0179.201911018 Copy

1.	Ramachandran VS, Rogers-Ramachandran D, Cobb S. Touching the phantom limb. Nature, 1995, 377(6549): 489-490.
2.	Altschuler EL, Wisdom SB, Stone L, et al. Rehabilitation of hemiparesis after stroke with a mirror. Lancet, 1999, 353(9169): 2035-2036.
3.	Hou S, Ivanhoe C, Li S. Botulinum toxin injection for spastic scapular dyskinesia after stroke: case series. Medicine (Baltimore), 2015, 94(32): e1300.
4.	Mirela Cristina L, Matei D, Ignat B, et al. Mirror therapy enhances upper extremity motor recovery in stroke patients. Acta Neurol Belg, 2015, 115(4): 597-603.
5.	Colomer C, NOé E, Llorens R. Mirror therapy in chronic stroke survivors with severely impaired upper limb function:a randomized controlled trial. Eur J Phys Rehabil Med, 2016, 52(3): 271-278.
6.	Kim HJ, Lee GC, Song CH. Effect of functional electrical stimulation with mirror therapy on upper extremity motor function in poststroke patients. J Stroke Cerebrovasc Dis, 2014, 23(4): 655-661.
7.	杨延辉, 张洁, 董媛媛, 等. 重复经颅磁刺激联合镜像疗法对脑卒中上肢和手康复的个案报道. 中国康复理论与实践, 2019, 25(5): 590-592.
8.	李亚斌, 冯海霞, 王红霞, 等. 经颅直流电刺激结合镜像神经元康复训练对脑卒中患者上肢功能及体感诱发电位的影响. 中国康复, 2019, 34(4): 187-190.
9.	徐宁, 王玉宇, 徐志良, 等. 补阳还五汤配合镜像疗法对气虚血瘀证脑卒中患者上肢运动功能恢复的疗效观察. 上海中医药大学学报, 2017, 31(3): 30-32, 39.
10.	谢晶军, 李金霞, 孙琦, 等. 针刺结合镜像疗法治疗卒中后偏瘫上肢功能障碍的疗效观察. 上海针灸杂志, 2018, 37(5): 494-498.
11.	Kerr A, Dawson J, Robertson C, et al. Sit to stand activity during stroke rehabilitation. Top Stroke Rehabil, 2017, 24(8): 562-566.
12.	Fini NA, Holland AE, Keating J, et al. How physically active are people following stroke? Systematic review and quantitative synthesis. Phys Ther, 2017, 97(7): 707-717.
13.	Sütbeyaz S, Yavuzer G, Sezer N, et al. Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Arch Phys Med Rehabil, 2007, 88(5): 555-559.
14.	Arya KN, Pandian S, Kumar V. Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke:a randomized controlled trial. Neuropsychol Rehabil, 2019, 29(8): 1193-1210.
15.	Xu Q, Guo F, Salem HMA, et al. Effects of mirror therapy combined with neuromuscular electrical stimulation on motor recovery of lower limbs and walking ability of patients with stroke: a randomized controlled study. Clin Rehabil, 2017, 31(12): 1583-1591.
16.	Cha HG, Kim MK. The effects of repetitive transcranial magnetic stimulation integrated mirror therapy on the gait of chronic stroke patients. J Magn, 2015, 20(2): 133-137.
17.	Bartolomeo P, Thiebaut de Schotten M, Doricchi F. Left unilateral neglect as a disconnection syndrome. Cereb Cortex, 2007, 17(11): 2479-2490.
18.	Stone SP, Halligan PW, Greenwood RJ. The incidence of neglect phenomena and related disorders in patients with an acute right or left hemisphere stroke. Age Ageing, 1993, 22(1): 46-52.
19.	Pandian JD, Arora R, Kaur P, et al. Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial. Neurology, 2014, 83(11): 1012-1017.
20.	侯红, 吴玉霞, 王彤. 镜像治疗对脑卒中偏侧忽略症改善的疗效观察. 中国康复, 2018, 33(4): 283-285.
21.	董继革. 镜像疗法结合运动想象对脑卒中后单侧忽略症的临床疗效观察. 国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集, 珠海, 2016. 长沙: 湖南中医药大学期刊杂志社, 2016: 433-434.
22.	Fandler S, Gattringer T, Eppinger S, et al. Frequency and predictors of dysphagia in patients with recent small subcortical infarcts. Stroke, 2017, 48(1): 213-215.
23.	Ushioda T, Watanabe Y, Sanjo Y, et al. Visual and auditory stimuli associated with swallowing activate mirror neurons:a magnetoencephalography study. Dysphagia, 2012, 27(4): 504-513.
24.	龙耀斌, 张红敏. 镜像疗法对急性期脑卒中吞咽障碍的效果. 中国康复理论与实践, 2015, 21(9): 1078-1081.
25.	龙耀斌, 黎伟雄, 黄雅琳, 等. 镜像疗法结合进食训练改善脑梗死患者的吞咽功能. 中国老年学杂志, 2019, 39(9): 2078-2081.
26.	薛赟资, 白玉龙. 脑卒中后复杂性区域性疼痛综合征的康复. 上海医药, 2017, 38(1): 12-18, 24.
27.	Cacchio A, De Blasis E, De Blasis V, et al. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke. Neurorehabil Neural Repair, 2009, 23(8): 792-799.
28.	Thieme H, Mehrholz J, Pohl M, et al. Mirror therapy for improving motor function after stroke. Stroke, 2013, 44(1): e1-e2.
29.	王英. 镜像疗法对脑卒中后复杂性局部疼痛综合征Ⅰ型的疗效分析. 神经损伤与功能重建, 2018, 13(5): 252-254.
30.	仰唯栋, 马妍洁. 电针联合镜像疗法治疗卒中后肩手综合征Ⅰ期疗效观察. 上海针灸杂志, 2019, 38(5): 492-496.
31.	Ishihara Y, Kodaka K. Vision-driven kinesthetic illusion in mirror visual feedback. Iperception, 2018, 9(3): 2041669518782994.
32.	Nojima I, Mima T, Koganemaru S, et al. Human motor plasticity induced by mirror visual feedback. J Neurosci, 2012, 32(4): 1293-1300.
33.	Garry MI, Loftus A, Summers JJ. Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability. Exp Brain Res, 2005, 163(1): 118-122.
34.	Michielsen ME, Selles RW, Geest JNVD, et al. Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: a phaseⅡ randomized controlled trial. Neurorehabil Neural Repair, 2011, 25(3): 223-233.
35.	Rizzolatti G, Fadiga L, Gallese V, et al. Premotor cortex and the recognition of motor actions. Brain Res Cogn Brain Res, 1996, 3(2): 131-141.
36.	Mukamel R, Ekstrom AD, Kaplan J, et al. Single-neuron responses in humans during execution and observation of actions. Curr Biol, 2010, 20(8): 750-756.
37.	Buccino G, Vogt S, Ritzl A, et al. Neural circuits underlying imitation learning of hand actions: an event-related fMRI study. Neuron, 2004, 42(2): 323-334.
38.	Frenkel-Toledo S, Liebermann DG, Bentin S, et al. Dysfunction of the human mirror neuron system in ideomotor apraxia: evidence from mu suppression. J Cogn Neurosci, 2016, 28(6): 775-791.
39.	Perry A, Saunders SN, Stiso J, et al. Effffects of prefrontal cortex damage on emotion understanding: EEG and behavioural evidence. Brain, 2017, 140(4): 1086-1099.
40.	Zult T, Howatson G, Kádár EE, et al. Role of the mirror-neuron system in cross- education. Sports Med, 2014, 44(2): 159-178.
41.	Iacoboni M, Woods RP, Brass M, et al. Cortical mechanisms of human imitation. Science, 1999, 286(5449): 2526.
42.	Iacoboni M. Neural mechanisms of imitation. Curr Opin Neurobiol, 2005, 15(6): 632-637.
43.	Garrison KA, Winstein CJ, Aziz-Zadeh L. The mirror neuron system: a neural substrate for methods in stroke rehabilitation. Neurorehabil Neural Repair, 2010, 24(5): 404-412.
44.	Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain, 2009, 132(Pt 7): 1693-1710.
45.	Ramachandran VS, Rogers-Ramachandran D. Mirror feedback assisted recovery from hemiparesis following stroke. In reply to morkisch et al.: how to perform mirror therapy after stroke? Evidence from a meta-analysis. Restor Neurol Neurosci, 2019, 37(5): 437-443.
46.	Ramachandran VS. Phantom limbs, neglect syndromes, repressed memories, and Freudian psychology. Int Rev Neurobiol, 1994, 37: 291-333.
47.	Hummel FC, Cohen LG. Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke?. Lancet Neurol, 2006, 5(8): 708-712.
48.	Murase N, Duque J, Mazzocchio R, Cohen LG. Influence of interhemispheric interactions on motor function in chronic stroke. Ann Neurol, 2004, 55(3): 400-409.
49.	Perez MA, Cohen LG. Mechanisms underlying functional changes in the primary motor cortex ipsilateral to an active hand. J Neurosci, 2008, 28(22): 5631-5640.
50.	Neva JL, Vesia M, Singh AM, et al. Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex. Behav Brain Res, 2014, 261: 289-296.
51.	陈洪淼, 冯嘉诚, 黄千树, 等. 一种基于镜像原理的神经-肌肉康复训练器设计. 中国康复医学杂志, 2018, 33(7): 850-851, 860.
52.	荣积峰, 丁力, 张雯, 等. 康复机器人结合镜像疗法对脑卒中偏瘫患者上肢功能的效果. 中国康复理论与实践, 2019, 25(6): 709-713.
53.	梁爽, 邹任玲. 基于镜像疗法的上肢手功能康复游戏系统设计. 软件导刊, 2018, 17(6): 116-119.

1. Ramachandran VS, Rogers-Ramachandran D, Cobb S. Touching the phantom limb. Nature, 1995, 377(6549): 489-490.
2. Altschuler EL, Wisdom SB, Stone L, et al. Rehabilitation of hemiparesis after stroke with a mirror. Lancet, 1999, 353(9169): 2035-2036.
3. Hou S, Ivanhoe C, Li S. Botulinum toxin injection for spastic scapular dyskinesia after stroke: case series. Medicine (Baltimore), 2015, 94(32): e1300.
4. Mirela Cristina L, Matei D, Ignat B, et al. Mirror therapy enhances upper extremity motor recovery in stroke patients. Acta Neurol Belg, 2015, 115(4): 597-603.
5. Colomer C, NOé E, Llorens R. Mirror therapy in chronic stroke survivors with severely impaired upper limb function:a randomized controlled trial. Eur J Phys Rehabil Med, 2016, 52(3): 271-278.
6. Kim HJ, Lee GC, Song CH. Effect of functional electrical stimulation with mirror therapy on upper extremity motor function in poststroke patients. J Stroke Cerebrovasc Dis, 2014, 23(4): 655-661.
7. 杨延辉, 张洁, 董媛媛, 等. 重复经颅磁刺激联合镜像疗法对脑卒中上肢和手康复的个案报道. 中国康复理论与实践, 2019, 25(5): 590-592.
8. 李亚斌, 冯海霞, 王红霞, 等. 经颅直流电刺激结合镜像神经元康复训练对脑卒中患者上肢功能及体感诱发电位的影响. 中国康复, 2019, 34(4): 187-190.
9. 徐宁, 王玉宇, 徐志良, 等. 补阳还五汤配合镜像疗法对气虚血瘀证脑卒中患者上肢运动功能恢复的疗效观察. 上海中医药大学学报, 2017, 31(3): 30-32, 39.
10. 谢晶军, 李金霞, 孙琦, 等. 针刺结合镜像疗法治疗卒中后偏瘫上肢功能障碍的疗效观察. 上海针灸杂志, 2018, 37(5): 494-498.
11. Kerr A, Dawson J, Robertson C, et al. Sit to stand activity during stroke rehabilitation. Top Stroke Rehabil, 2017, 24(8): 562-566.
12. Fini NA, Holland AE, Keating J, et al. How physically active are people following stroke? Systematic review and quantitative synthesis. Phys Ther, 2017, 97(7): 707-717.
13. Sütbeyaz S, Yavuzer G, Sezer N, et al. Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Arch Phys Med Rehabil, 2007, 88(5): 555-559.
14. Arya KN, Pandian S, Kumar V. Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke:a randomized controlled trial. Neuropsychol Rehabil, 2019, 29(8): 1193-1210.
15. Xu Q, Guo F, Salem HMA, et al. Effects of mirror therapy combined with neuromuscular electrical stimulation on motor recovery of lower limbs and walking ability of patients with stroke: a randomized controlled study. Clin Rehabil, 2017, 31(12): 1583-1591.
16. Cha HG, Kim MK. The effects of repetitive transcranial magnetic stimulation integrated mirror therapy on the gait of chronic stroke patients. J Magn, 2015, 20(2): 133-137.
17. Bartolomeo P, Thiebaut de Schotten M, Doricchi F. Left unilateral neglect as a disconnection syndrome. Cereb Cortex, 2007, 17(11): 2479-2490.
18. Stone SP, Halligan PW, Greenwood RJ. The incidence of neglect phenomena and related disorders in patients with an acute right or left hemisphere stroke. Age Ageing, 1993, 22(1): 46-52.
19. Pandian JD, Arora R, Kaur P, et al. Mirror therapy in unilateral neglect after stroke (MUST trial): a randomized controlled trial. Neurology, 2014, 83(11): 1012-1017.
20. 侯红, 吴玉霞, 王彤. 镜像治疗对脑卒中偏侧忽略症改善的疗效观察. 中国康复, 2018, 33(4): 283-285.
21. 董继革. 镜像疗法结合运动想象对脑卒中后单侧忽略症的临床疗效观察. 国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集, 珠海, 2016. 长沙: 湖南中医药大学期刊杂志社, 2016: 433-434.
22. Fandler S, Gattringer T, Eppinger S, et al. Frequency and predictors of dysphagia in patients with recent small subcortical infarcts. Stroke, 2017, 48(1): 213-215.
23. Ushioda T, Watanabe Y, Sanjo Y, et al. Visual and auditory stimuli associated with swallowing activate mirror neurons:a magnetoencephalography study. Dysphagia, 2012, 27(4): 504-513.
24. 龙耀斌, 张红敏. 镜像疗法对急性期脑卒中吞咽障碍的效果. 中国康复理论与实践, 2015, 21(9): 1078-1081.
25. 龙耀斌, 黎伟雄, 黄雅琳, 等. 镜像疗法结合进食训练改善脑梗死患者的吞咽功能. 中国老年学杂志, 2019, 39(9): 2078-2081.
26. 薛赟资, 白玉龙. 脑卒中后复杂性区域性疼痛综合征的康复. 上海医药, 2017, 38(1): 12-18, 24.
27. Cacchio A, De Blasis E, De Blasis V, et al. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke. Neurorehabil Neural Repair, 2009, 23(8): 792-799.
28. Thieme H, Mehrholz J, Pohl M, et al. Mirror therapy for improving motor function after stroke. Stroke, 2013, 44(1): e1-e2.
29. 王英. 镜像疗法对脑卒中后复杂性局部疼痛综合征Ⅰ型的疗效分析. 神经损伤与功能重建, 2018, 13(5): 252-254.
30. 仰唯栋, 马妍洁. 电针联合镜像疗法治疗卒中后肩手综合征Ⅰ期疗效观察. 上海针灸杂志, 2019, 38(5): 492-496.
31. Ishihara Y, Kodaka K. Vision-driven kinesthetic illusion in mirror visual feedback. Iperception, 2018, 9(3): 2041669518782994.
32. Nojima I, Mima T, Koganemaru S, et al. Human motor plasticity induced by mirror visual feedback. J Neurosci, 2012, 32(4): 1293-1300.
33. Garry MI, Loftus A, Summers JJ. Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability. Exp Brain Res, 2005, 163(1): 118-122.
34. Michielsen ME, Selles RW, Geest JNVD, et al. Motor recovery and cortical reorganization after mirror therapy in chronic stroke patients: a phaseⅡ randomized controlled trial. Neurorehabil Neural Repair, 2011, 25(3): 223-233.
35. Rizzolatti G, Fadiga L, Gallese V, et al. Premotor cortex and the recognition of motor actions. Brain Res Cogn Brain Res, 1996, 3(2): 131-141.
36. Mukamel R, Ekstrom AD, Kaplan J, et al. Single-neuron responses in humans during execution and observation of actions. Curr Biol, 2010, 20(8): 750-756.
37. Buccino G, Vogt S, Ritzl A, et al. Neural circuits underlying imitation learning of hand actions: an event-related fMRI study. Neuron, 2004, 42(2): 323-334.
38. Frenkel-Toledo S, Liebermann DG, Bentin S, et al. Dysfunction of the human mirror neuron system in ideomotor apraxia: evidence from mu suppression. J Cogn Neurosci, 2016, 28(6): 775-791.
39. Perry A, Saunders SN, Stiso J, et al. Effffects of prefrontal cortex damage on emotion understanding: EEG and behavioural evidence. Brain, 2017, 140(4): 1086-1099.
40. Zult T, Howatson G, Kádár EE, et al. Role of the mirror-neuron system in cross- education. Sports Med, 2014, 44(2): 159-178.
41. Iacoboni M, Woods RP, Brass M, et al. Cortical mechanisms of human imitation. Science, 1999, 286(5449): 2526.
42. Iacoboni M. Neural mechanisms of imitation. Curr Opin Neurobiol, 2005, 15(6): 632-637.
43. Garrison KA, Winstein CJ, Aziz-Zadeh L. The mirror neuron system: a neural substrate for methods in stroke rehabilitation. Neurorehabil Neural Repair, 2010, 24(5): 404-412.
44. Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain, 2009, 132(Pt 7): 1693-1710.
45. Ramachandran VS, Rogers-Ramachandran D. Mirror feedback assisted recovery from hemiparesis following stroke. In reply to morkisch et al.: how to perform mirror therapy after stroke? Evidence from a meta-analysis. Restor Neurol Neurosci, 2019, 37(5): 437-443.
46. Ramachandran VS. Phantom limbs, neglect syndromes, repressed memories, and Freudian psychology. Int Rev Neurobiol, 1994, 37: 291-333.
47. Hummel FC, Cohen LG. Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke?. Lancet Neurol, 2006, 5(8): 708-712.
48. Murase N, Duque J, Mazzocchio R, Cohen LG. Influence of interhemispheric interactions on motor function in chronic stroke. Ann Neurol, 2004, 55(3): 400-409.
49. Perez MA, Cohen LG. Mechanisms underlying functional changes in the primary motor cortex ipsilateral to an active hand. J Neurosci, 2008, 28(22): 5631-5640.
50. Neva JL, Vesia M, Singh AM, et al. Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex. Behav Brain Res, 2014, 261: 289-296.
51. 陈洪淼, 冯嘉诚, 黄千树, 等. 一种基于镜像原理的神经-肌肉康复训练器设计. 中国康复医学杂志, 2018, 33(7): 850-851, 860.
52. 荣积峰, 丁力, 张雯, 等. 康复机器人结合镜像疗法对脑卒中偏瘫患者上肢功能的效果. 中国康复理论与实践, 2019, 25(6): 709-713.
53. 梁爽, 邹任玲. 基于镜像疗法的上肢手功能康复游戏系统设计. 软件导刊, 2018, 17(6): 116-119.

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