Unilateral mirror therapy may improve upper limb motor recovery after stroke but bilateral mirror therapy provides little or no additional benefit: a systematic review

IF 9.4 1区医学 Q1 ORTHOPEDICS

Journal of Physiotherapy Pub Date : 2026-01-01 Epub Date: 2025-12-20 DOI:10.1016/j.jphys.2025.12.008

Augusto Boening , Louise Ada , Maria Tereza M Alvarenga , Aline A Scianni , Lucas R Nascimento

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引用次数: 0

Abstract

Question

Is mirror therapy, using only the intact upper limb (unilateral), superior to the same amount and type of practice without the mirror at reducing upper limb impairments or activity limitations? Is mirror therapy, using the intact and the affected upper limb (bilateral), superior to the same amount and type of practice without the mirror at reducing upper limb impairments or activity limitations?

Design

Systematic review of randomised trials with meta-analysis.

Participants

Adults at any time after stroke of any severity.

Intervention

Supervised mirror therapy for the upper limb.

Outcome measures

Motor impairments and/or activities.

Results

A total of 19 trials, involving 618 participants, were included. The mean PEDro score of the trials was 6 (range 3 to 8). Low-level evidence indicates that unilateral mirror therapy may have a moderate effect on motor recovery (SMD 0.48, 95% CI 0.14 to 0.82) and moderate level evidence indicates that this is similar in terms of the Fugl-Meyer Assessment (MD 5 out of 66 points, 95% CI 0 to 10). Moderate-level evidence indicates that bilateral mirror therapy has little or no effect on motor recovery (SMD 0.15, 95% CI –0.07 to 0.38) and moderate level evidence indicates that this is similar in terms of the Fugl-Meyer Assessment (MD 2 out of 66 points, 95% CI –1 to 6).

Conclusion

This systematic review suggests that unilateral mirror therapy may improve motor recovery after stroke. In contrast, bilateral mirror therapy appears to offer little benefit compared with practice without the mirror.

Registration

PROSPERO (CRD420251038374).

查看原文本刊更多论文

单侧镜像治疗可能改善中风后上肢运动恢复，但双侧镜像治疗提供很少或没有额外的好处：一项系统综述。

问题：仅使用完整上肢（单侧）的镜像疗法在减少上肢损伤或活动限制方面是否优于不使用镜像的相同数量和类型的练习？镜像疗法，使用完整的和受影响的上肢（双侧），在减少上肢损伤或活动限制方面是否优于相同数量和类型的无镜像练习？设计：采用荟萃分析对随机试验进行系统评价。参与者：任何严重程度中风后的任何时间的成年人。干预：上肢监督镜像治疗。结果测量：运动障碍和/或活动。结果：共纳入19项试验，618名受试者。试验的平均PEDro评分为6分（范围3至8分）。低水平证据表明，单侧镜像治疗可能对运动恢复有中等影响（SMD 0.48, 95% CI 0.14至0.82），中等水平证据表明，这与Fugl-Meyer评估（MD 5 / 66分，95% CI 0至10）相似。中等水平的证据表明，双侧镜像治疗对运动恢复的影响很小或没有影响（SMD为0.15,95% CI为-0.07至0.38），中等水平的证据表明，这与Fugl-Meyer评估（dm2 / 66分，95% CI为-1至6）相似。结论：本系统综述提示单侧镜像治疗可改善脑卒中后的运动恢复。相比之下，双侧镜像治疗与不使用镜像的治疗相比似乎没有什么好处。注册：普洛斯彼罗（CRD420251038374）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Physiotherapy ORTHOPEDICS-REHABILITATION

CiteScore

11.40

自引率

7.40%

发文量

审稿时长

72 days

期刊介绍： The Journal of Physiotherapy is the official journal of the Australian Physiotherapy Association. It aims to publish high-quality research with a significant impact on global physiotherapy practice. The journal's vision is to lead the field in supporting clinicians to access, understand, and implement research evidence that will enhance person-centred care. In January 2008, the Journal of Physiotherapy became the first physiotherapy journal to adhere to the ICMJE requirement of registering randomized trials with a recognized Trial Registry. The journal prioritizes systematic reviews, clinical trials, economic analyses, experimental studies, qualitative studies, epidemiological studies, and observational studies. In January 2014, it also became the first core physiotherapy/physical therapy journal to provide free access to editorials and peer-reviewed original research. The Australian Physiotherapy Association extended their support for excellence in physiotherapy practice by sponsoring open access publication of all Journal of Physiotherapy content in 2016. As a result, all past, present, and future journal articles are freely accessible, and there are no author fees for publication.