Effects of mirror therapy on spasticity and sensory impairment after stroke: Systematic review and meta‐analysis

Abstract

AbstractObjectiveTo review and synthesize existing evidence on the effectiveness of mirror therapy (MT) compared to active exercise‐based interventions (ie, cross‐training and conventional exercise) for reducing spasticity and sensory impairment in stroke survivors.TypeSystematic Review and Metanalysis.Literature SurveyPubmed/MEDLINE, Cochrane, Embase, CINAHL, and Physiotherapy Evidence Database (PEDro), were searched.MethodologyRandomized controlled trials (RCTs) that investigated MT effectiveness in improving spasticity and sensory impairment in stroke survivors compared to a control group.SynthesisFifteen RCTs (653 volunteers) were included. Spasticity improvements achieved with MT were similar to those obtained with cross‐training (standard mean difference [SMD]: 0.12, 95% confidence interval [CI]: −0.43 to 0.68). In addition, when further combined with conventional exercise, spasticity improved similarly in both groups (SMD: 0.10, 95% CI: −0.16, 0.36). Lastly, when MT plus exercise was compared to exercise alone, spasticity decreased in both groups (SMD: 0.16, 95% CI: −0.16 to 0.48). Nevertheless, none of the Interventions seem effective on sensory impairment (SMD: 0.27, 95% CI: −0.28 to 0.81).ConclusionsMT is equally effective as other exercise therapies, such as cross‐training and conventional exercise, for improving spasticity in stroke survivors, whereas none of the explored interventions yielded beneficial effects on sensory impairment. Further well‐designed RCTs are needed to confirm the results.