| Objective:Meta-analysis of the effect of mirror therapy shoulder-hand syndrome after stroke patients;The patients with shoulder-hand syndrome after stroke were taken as the research object.The mirror therapy group and conventional rehabilitation training group were taken as the control group.The clinical effect of mirror therapy combined with conventional rehabilitation training on shoulder-hand syndrome after stroke was observed.Methods:1.Meta-analysis of mirror therapy for shoulder-hand syndrome after stroke Randomized controlled trials of mirror therapy for shoulder-hand syndrome after stroke were collected by computer retrieval.A total of 327 literatures were retrieved.All the literatures were imported by Wang V5 and 197 were obtained by excluding130 duplicated literatures.After reading the title,abstract and original text,192 articles which did not meet the requirements were excluded,and finally 5 articles were included.216 samples were included,107 in the mirror group and 109 in the control group.The literature quality evaluation was B-level.Literatures were screened according to the established inclusion criteria and exclusion criteria.Bias assessment risk tools were used to evaluate the quality of the included literature and meta-analysis was carried out;2.Clinical effectiveness of mirror therapy for shoulder-hand syndrome after stroke72 patients with shoulder-hand syndrome after stroke were randomly divided into three groups,24 patients in the conventional rehabilitation training group(group A),and 24 patients in the mirror therapy group(group B).24 patients in mirror therapy combined with conventional rehabilitation training group(group C),Group A was given conventional rehabilitation training for upper limbs,group B was given mirror therapy,and group C was treated with mirror therapy combined with conventional rehabilitation training of upper limbs.All three groups were treated once a day for 30 minutes,5 times for one week,two days rest in the middle,and the total course of treatment is four weeks.Pain(VAS),swelling degree of the palm of the affected limb,temperature difference between the shoulders of both upper limbs and the back of the hand(?T),range of motion of upper limbs(Fugl-Meyer),activities of daily living(modified Barthel index(MBI))and depression(BAI)were assessed before and after treatment,and pain(VAS)and activities of daily living(modified Barthel index(MBI))were followed for 1 month,finally,The above indexes were were compared and analyzed between groups.Results:1.Meta-analysis of mirror therapy for shoulder-hand syndrome after stroke;(1)Document retrieval and quality evaluation A total of 327 papers were obtained.All the papers were imported by Wang V5,and 197 papers were obtained by excluding 130 duplicate papers.After reading the title,abstract and original text,192 articles which did not meet the requirements were excluded,and finally 5 articles were included.216 samples were included,107 in the mirror group and 109 in the control group.The literature quality evaluation was B-level.(2)Analysis results(1)Pain score: MD=-1.82,95% CI [-2.50,-1.14],P < 0.01;VAS score in active state: MD=-3.05,95% CI [-3.95,-2.16],P < 0.01;(2)Motor function:hand FMA score: MD = 6.00,95% CI [3.44,8.56],P < 0.01;wrist FMA score: MD =3.00,95% CI [1.77,4.23],P < 0.01;(3)Upper extremity BRS score: MD = 1.00,95%CI [-0.02,2.02],P = 0.05;Hand BRS score: MD = 1.00,95% CI [0.11,1.89],P <0.05.2.Clinical effectiveness of mirror therapy for shoulder-hand syndrome after stroke(1)Clinical efficacy: The effective rate of group C was 52.38%,which was markedly higher than 22.73% in group A and 25.00% in group B.the curative effect of group A and group B was similar(P > 0.05).(2)Pain of affected limbs(VAS):The VAS scores of the three groups were significantly improved compared with those before treatment(P<0.01),VAS scores of group C were significantly lower than those of group A(P < 0.01).Pain scores of group C were markedly lower than those of group B(P < 0.05).VAS scores of group A and group B had no significant difference(p > 0.05).(3)Swelling degree of the palm of the affected limb:The swelling degree of the palm was significantly relieved after treatment in the three groups(P<0.01).The swelling degree of the palm of the affected limb in group C was not dramatically improved compared with the group A(P>0.05).The swelling degree of the palm of the affected limb was significantly lower than that of the group B(P<0.01).and there was no significant difference in the degree of palm swelling of affected limbs between groups A and B(P > 0.05).(4)Bilateral temperature difference(?T):(1)?Comparison of temperature difference between the back of the hand: The temperature difference of back of hand in three groups after treatment was Prominently lower than that before treatment(p < 0.01).The temperature difference of group C was significantly lower than that of group A and group B(P < 0.05).There was no significant difference between group A and group B(p > 0.05).There was no significant difference between group A and group B(p > 0.05).(2)?The temperature difference of shoulder: the temperature difference of shoulder in three groups after treatment was dramatically lower than that before treatment(p < 0.05).Group C had no significant difference in temperature difference was significantly compared with that of group A and B(p < 0.05).and there was no significant difference in temperature difference between groups A and B(P > 0.05).(5)Upper limb joint mobility(Fugl-Meyer): The upper limb joint mobility was significantly improved after treatment in the three groups(p<0.01);There was no significant difference between group C and group A(P > 0.05),group C showed significant improvement in upper limb joint mobility compared with group B(P<0.01),and there was no markedly difference between group A and group B(p >0.05).(6)Upper limb motor function(Fugl-Meyer): The upper limb motor function of the three groups was significantly higher than that before treatment(p<0.05);the upper limb motor function score of group C was significantly better than that of group A and B(P<0.05).There was no significant difference in the scores of upper limb motor function between the two groups(P>0.05).(7)Depressive mood(BDI): the depression scores of the three groups were significantly lower than those before treatment(p<0.01);the depression scores of group C were significantly lower than those of group A and group B(P < 0.05);here was no markedly difference in the depression scores between group A and group B(p > 0.05).(8)Activity of daily living(modified Barthel index)(MBI): MBI scores of each group were significantly improved after treatment(P < 0.01);the MBI scores of group C were not significantly different from those of group A(P>0.05).MBI scores of group C were significantly higher than those of group B(P < 0.05),and MBI scores of group A and group B were not significantly different(P > 0.05).(9)Follow-up for 1 month:(1)Pain(VAS): VAS scores of the three groups were markedly decreased than those before treatment(P < 0.01);VAS scores of group C were significantly lower than those of group A and group B(P < 0.05);VAS scores of group A and group B were not significantly different(P > 0.05);(2)Activity of daily living: MBI scores of the three groups were dramatically lower than those before treatment(P < 0.01);MBI scores of the three groups were not significantly different after therapy(P>0.05).Conclusion:1.Based on literature review,mirror therapy has a good effect on improving upper limb motor function and ADL in stroke patients,however,the number and quality of the included documents are relatively small and need further study.2.Conventional rehabilitation training and mirror therapy can improve pain,swelling degree of palm,temperature difference between shoulder and back of hand(T),range of motion of upper limb,motor function of upper limb,activity of daily living and depression in patients with shoulder-hand syndrome after stroke.Mirror therapy is effective in relieving pain.Conventional rehabilitation training has obvious advantages in improving swelling of affected limbs and joint activity.Mirror therapy combined with conventional rehabilitation training has a better therapeutic effect in the treatment of shoulder-hand syndrome after stroke. |
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