Effect of mirror therapy on upper limb function and cerebral cortex activity in patients with type Ⅰ complex re-gional pain syndrome after stroke:a randomized controlled trial
10.3969/j.issn.1006-9771.2024.10.011
- VernacularTitle:镜像疗法对脑卒中后Ⅰ型复杂区域性疼痛综合征患者上肢功能及大脑皮质活动效果的随机对照试验
- Author:
Cuifeng WEN
1
,
2
;
Ru YA
;
Hao HUANG
;
Xuemei LIAO
;
Yulong BAI
Author Information
1. 上海中医药大学附属第三康复医院重症康复科,上海市 200436
2. 同济大学医学院,上海市 200065
- Keywords:
stroke;
complex regional pain syndrome;
mirror therapy;
upper limb;
cerebral cortex;
randomized controlled trial
- From:
Chinese Journal of Rehabilitation Theory and Practice
2024;30(10):1203-1214
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of mirror therapy on upper limb function and cortical activity in patients with type I complex regional pain syndrome(CRPS)after stroke. Methods A total of 72 post-stroke patients with type I CRPS were recruited at the Third Rehabilitation Hospital Affiliat-ed to Shanghai University of Traditional Chinese Medicine from October,2017 to February,2022.They were ran-domly divided into control group(n=36)and mirror therapy group(n=36).The control group received conven-tional rehabilitation training,while the mirror therapy group received mirror therapy in addition.Before treat-ment,as well as at three and six weeks after treatment,they were evaluated using the Visual Analog Scale(VAS)for pain,modified Barthel Index(MBI),edema volume and Brunnstrom stage.Resting-state data were collected for 440 seconds using a 32-channel functional near-infrared spectroscopy(fNIRS)system. Results After treatment,VAS scores significantly improved in each group,showing better after six weeks than after three weeks(P<0.01).The mirror therapy group was better than the control group after six weeks(P<0.05).MBI scores also significantly improved in each group,showing better after six weeks than after three weeks(P<0.001).Edema volume significantly decreased in each group(Z>30.113,P<0.001),while the mirror therapy group was better than the control group after six weeks(Z=-3.347,P=0.001).Edema volume in the mirror therapy group significantly reduced at both three and six weeks(Z<-0.667,P<0.01),with a stronger effect ob-served after six weeks(Z=-0.667,P=0.005).Brunnstrom stages improved significantly in each group(Z>29.714,P<0.001),while the mirror therapy group was better than the control group after six weeks(Z=-2.046,P=0.041).After treatment,the control group showed strong connectivity between right M1 and right primary so-matosensory cortex,while the mirror therapy group demonstrated stronger connectivity between left M1 and right M1,right primary somatosensory cortex,right pre-motor and supplementary motor cortex.Connectivity be-tween left and right primary somatosensory cortex increased in mirror therapy group,as well as the connectivity between left pre-motor-supplementary motor cortex and right M1,right pre-motor-supplementary motor cortex and left primary somatosensory cortex,left M1 and left primary somatosensory cortex,and left primary somato-sensory cortex and right M1(∣t∣>3.402,P<0.01). Conclusion Mirror therapy may relieve pain and edema,and improve upper limb motor function in post-stroke patients with type I CRPS,which may associate with stonger connectivity between sensory regions on the unaffected side and sensory-motor regions on the affected side,promoting sensorimotor cortical reorganization.
