Mirror, mirror, on the wall… Okay, let’s get that mirror off the wall if we want to help stroke patients regain muscle strength and control to improve their walking.
Mirror therapy is a technique that we know works in helping patients regain arm function by having them reflect the movements of their unaffected arm so that it looks like the affected side is moving. Seeing the reflection tricks the brain into thinking the affected side is moving naturally and, therefore, activates the brain. In turn, the brain relearns how to use the muscles.
Now, researchers are looking into whether this method can also help patients who suffer from decreased leg function.
Watch this video for a clear demonstration of some foot exercises using a mirror.
A review of mirror studies
The researchers of this study evaluated 13 trials that included a total of 572 patients. The patients in these trials held a mirror between their knees so that the unaffected leg reflected and looked like the affected leg. This created the illusion that the affected leg performed the action. This mirror image helps the brain to be aware of the leg’s location and reduces ‘learned’ nonuse. In six of the studies, the patients moved both legs. In seven studies, patients only used the unaffected leg.
The patients had mirror therapy three to six days a week for two weeks to three months. Each session lasted between 15 to 30 minutes.
Results of the mirror training
The primary finding was that mirror therapy produced improvements in walking speed, balance, leg function, and passive range of motion of the ankle. Patients saw better results when this therapy was used right after a stroke, supporting the notion that early intervention is crucial for success.
Moving both legs was more effective than only using the unaffected leg. However, there was no evidence to support that mirror therapy improved spasticity or mobility of the ankle joint muscles. The results of this study are consistent with the results of some earlier reviews.
Although researchers saw a favorable effect of mirror therapy, this finding did not have much clinical significance because the average walking speed and distance of subjects in seven of the studies improved only a little after treatment.
Despite this, mirror therapy appears to be promising for leg function, but there is not enough evidence yet to suggest when and how to approach it. Further research is needed. Check with your therapist to see if this is something for you. Mirror therapy is something that you can try at home with a mirror and some simple exercises.
The lead author of this study is Yi Li, Qingchuan Wei, Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People’s Republic of China.
Mirror therapy can be a valuable extra exercise you can do at home.