Home mirror therapy: A randomized controlled pilot study comparing unimanual and bimanual mirror therapy for improved upper limb function post-stroke

Research Objectives: To compare bimanual mirror therapy (BMT) and unimanual mirror therapy (UMT) protocols, in upper extremity (UE) recovery post-stroke during a home program and to determine whether one is superior to the other. Design: Randomized, controlled, assessor blind pilot study. Setting: Outpatient stroke rehabilitation program in an urban setting. Participants: Subjects with first time unilateral stroke occurring at least 3 months prior with UE Fugl Meyer (FM) scores between 10 and 50 were randomized into 1 of 3 groups, UMT, BMT, or traditional OT (TOT). Interventions: All subjects received OT 2x/wk in the clinic with a home program for 30 minutes a day, 5d/wk for 6 wks, as per group allocation. Weekly sessions with the research OT occurred to progress the home program and monitor compliance. Main Outcome Measure(s): The UE Fugl Meyer, Action Research Arm Test (ARAT) and The Stroke Impact Scale (SIS). Results: Six subjects were enrolled, 50% male, age ranged from 34-73. All groups improved on the FM and ARAT; however, UMT had the greatest change score, followed by BMT then TOT in the FM (9.5,9,8) and ARAT (9,7,2). For SIS ADL, both UMT (20) and BMT (21) improved more than TOT (10), while for SIS strength, the UMT improved the most (10), as compared to TOT (7.5) and BMT (5). However, for SIS participation, the TOT improved the most (11), followed by BMT (6), then UMT (4). Conclusions: UMT may be more effective than BMT and TOT for improving motor recovery and function of the paretic upper extremity post-stroke, which would provide best practice methods for clinicians in stroke recovery. A larger sample size would draw more definitive conclusions.