irror Therapy Enhances Lower-Extremity Motor Recovery nd Motor Functioning After Stroke: A Randomized ontrolled Trial

Objective: To evaluate the effects of mirror therapy, using otor imagery training, on lower-extremity motor recovery nd motor functioning of patients with subacute stroke. Design: Randomized, controlled, assessor-blinded, 4-week rial, with follow-up at 6 months. Setting: Rehabilitation education and research hospital. Participants: A total of 40 inpatients with stroke (mean age, 3.5y), all within 12 months poststroke and without volitional nkle dorsiflexion. Interventions: Thirty minutes per day of the mirror therapy rogram, consisting of nonparetic ankle dorsiflexion moveents or sham therapy, in addition to a conventional stroke ehabilitation program, 5 days a week, 2 to 5 hours a day, for weeks. Main Outcome Measures: The Brunnstrom stages of motor ecovery, spasticity assessed by the Modified Ashworth Scale MAS), walking ability (Functional Ambulation Categories FAC]), and motor functioning (motor items of the FIM nstrument). Results: The mean change score and 95% confidence interal (CI) of the Brunnstrom stages (mean, 1.7; 95% CI, 1.2–2.1; s mean, 0.8; 95% CI, 0.5–1.2; P .002), as well as the FIM otor score (mean, 21.4; 95% CI, 18.2–24.7; vs mean, 12.5; 5% CI, 9.6–14.8; P .001) showed significantly more imrovement at follow-up in the mirror group compared with the ontrol group. Neither MAS (mean, 0.8; 95% CI, 0.4–1.2; vs ean, 0.3; 95% CI, 0.1–0.7; P .102) nor FAC (mean, 1.7; 5% CI, 1.2–2.1; vs mean, 1.5; 95% CI, 1.1–1.9; P .610) howed a significant difference between the groups. Conclusions: Mirror therapy combined with a conventional troke rehabilitation program enhances lower-extremity motor ecovery and motor functioning in subacute stroke patients.