Efficacy Of Mirror Therapy On Rehabilitation Of Upper Limbs In Patients With Stroke: A Meta-analysis

Objective:To evaluate the efficacy of mirror therapy on rehabilitation of upper limbs inpatients with stroke.Methods:CNKI, Wanfang Data, VIP, Dayi medical search, Baidu Library, PUBMED,MEDLINE、Cochrane library database were searched for the Randomized controlledtrials (RCTs) of mirror therapy on rehabilitation of upper limbs in patients with strokefrom the date of establishment of the databases to January2015. The bibliographies ofthe included studies were searched. Two independent researchers evaluated theincluded studies using the risk of bias provided by Cochrane library. The extracteddata were analyzed using RevMan5.2software and GRADEprofiler3.6.Results:7trials were discovered. Meta-analysis showed that compared with conventionalrehabilitation after4weeks treatment, mirror therapy increase Fugl-Meyer assessment(FMA)(Upper Limb) scores [WMD=8.30，95％C（I4.24,12.36）], the action researcharm test (ARAT) scores [WMD=4.26,95％CI（3.03,5.50）], motor assessment scale(MAS) scores [WMD=0.93,95％CI （0.80,1.06）],barthel index (BI) scores[WMD=4.90,95％CI （1.82,7.99）] and modify barthel index(MBI) scores[WMD=8.48,95％CI（0.36,16.59）]. Mirror therapy also did not increase visualanalogue scale (VAS) scores [WMD=-0.56,95％CI（-1.55,0.43）P=0.27] after6weeks of treatment. In the GRADE system, the scores of Fugl-Meyer assessment(FMA)(Upper Limb), the action research arm test (ARAT), barthel index (BI) after4weeks of treatment were of moderate quality. The action research arm test (ARAT)scores after6weeks of treatment was of moderate quality. Visual analogue scale (VAS)scores after4weeks of treatment were of low quality.Conclusion: The current evidence shows that mirror therapy can improve the function ofupper limb and activity of daily living in patients after stroke, and it is simple andcheaply. It is worth to recommend in clinical application, especially for self-training.Due to the limitation of small sample size, different rating scales and different risk ofbias in the7trails, more large-sample, high-quality RCTs with scientific methods andtechnical standard are required to definite efficacy of mirror therapy on rehabilitationof upper limbs in patients with stroke.