The Effectveness of Mirror Box Training and the Measurement of Fore Arm Bisection Task as a Prognostic Factor in Post Stroke Subjects

Abstract

Introduction: Stroke and upper limb hemiparesis which is a commonly seen impairment and is particularly problematic for activities of daily living. It is commonly believed that motor recovery occurs only in the first recovery occurs only in the first 6-12 months after stroke. One of the major goals in rehabilitation for survivors of central nervous system (CNS) trauma is the return to independence in activities of daily living the success of achieving plastic changes in the CNS after skill training appears to be dependent on the amount of practice from the particular skills. It has been proposed that positive changes in the cortical representation at the primary sensory motor areas are “activity dependent”, stressing therefore the importance of practice in acquisition of skills practice may be accomplished with overall movement. But the purpose of the present study is to find out the efficacy of mirror box training and the fore arm bisection taskl bdnf as a prognostic factor in post stroke subjects.
Objectives: To analyse the efficacy of mirror box training and the fore arm bisection task as a prognostic factor in post stroke subjects.
Methods: Sample size of 30 subjects were included, 15 in each group. The subjects in the experimental group were administered the mirror box training and general conventional physiotherapy treatment for a total of 4 weeks with five 1 hour sessions each week. The subjects in the controlled group were given one hour routine physiotherapy which includes stretching of the affected limb muscles, walking, general strengthening exercise and active assisted and active exercises five days per week for 3 weeks. Finally Fugl Meyer motor assessment scale and Motor assessment scales were administered to assess the recovery of affected extremity for the group before intervention and after intervention.
Results: Wilcoxon signed rank test, Mann Whitney U test, Chi square test, paired t test and un paired t test had been used to study the significance of study parameters Significance was assessed at 5% significance level. At the end of the study period percentage changes in scores of FMA post intervention in the experimental group was found to be significant (p=<0.014) where as in control group finding was not statistically significant (p=>0.317)
Analysis between the group was found to be significant (p=<0.029) on motor assessment scale. Percentage change in post intervention in experimental group was found to be significant (p=<0.009) where as in control group finding was not statistically significant (p=>0.169) .Analysis between the group was found to be significant (p=<0.05).
Conclusions: Mirror box training is effective with its long term follow up. And it is the potential to enhance the motor relearning in chronic post stroke subjects. It shows that cortical re organization and functional improvement can be seen following mental practice with motor imagery. Neuronal network involved in movement execution also active during practicing exercises infront of the mirror box .Thus mirror box training can be added in stroke rehabilitation, for improvement of valued activities of daily living.