Effects of mirror visual observation priming on upper extremity motor recovery after stroke: a pilot randomized controlled trial.

Abstract

Objective: To investigate the priming effects of mirror visual observation (MVO) on upper extremity (UE) motor recover after stroke.

Design: Randomized, controlled, observer -blinded study.

Setting: Rehabilitation Medicine Department in Tertiary Hospital.

Participants: Twenty individuals with first unilateral stroke within 1 week to 6 months.

Intervention: Participants were randomly divided into two groups: (1) the experimental group (EG) receiving MVO with task-oriented training (MVO+TOT); (2) the control group (CG) receiving sham MVO+TOT. The intervention consisted of 30 minutes of MVO or sham MVO, a 10-minute break, and 30 minutes of TOT daily, five days a week, for three weeks.

Main outcome measures: The primary outcome was the Fugl-Meyer Assessment Upper Extremity Motor Function Subscale (FMA_UE). The change of FMA_UE (ΔFMA_UE) before and after the intervention was assessed for clinical significance. The secondary outcomes included grip strength, the Action Research Arm Test (ARAT), and the Modified Barthel Index (MBI).

Results: All patients completed the trial without adverse reactions. The EG had a better treatment experience than the CG. Both groups showed improvements in FMA_UE, grip strength, ARAT, and MBI scores from baseline (P<0.05 for all). Post-intervention, there were no differences between the groups in grip strength, ARAT, and MBI scores (P>0.05 for all). However, the EG showed a better improvement in FMA_UE scores compared to the CG (P=0.044). The ΔFMA_UE of both groups surpassed the minimal clinically important difference (MCID). The average ΔFMA_UE difference between the groups was 10.80 (95% CI: 6.31 to 15.29), exceeding the MCID with statistical significance (P<0.001).

Conclusions: MVO demonstrates a priming effect that enhances the recovery of UE motor impairments post-stroke with clinical significance.