Effect Of Thermal Stimulation And Mirror Therapy On Hand Functions In Patients With Stroke: An Interventional Study

Background: Thermal stimulation can be used as an intervention to enhance sensory function. Activated areas by thermal stimulation are greater than those by tactile or mechanical stimulation. Mirror therapy creates the illusion of normal movement with the mirror image of the unaffected upper extremity. Thermal stimulation provides somatosensory stimulation that causes the forced use of the involved extremity as a protective response to heat which provokes volitional/reflexive motor activity. Somatosensory stimulation may induce brain plasticity. Purpose: This study was carried out to determine the effect of thermal stimulation and mirror therapy in the sensorimotor and functional recovery of hand in stroke patients with hand impairment. Methods: 18 stroke survivors were randomly assigned to Thermal Stimulation rehabilitation treatment and Mirror Therapy rehabilitation group (30 minutes daily for 3 weeks). Three measures, including Brunnstorm stage, Wolf motor Function Test, and Revised Nottingham Sensory Assessment scale was used as an outcome measure to assess the motor and sensory recovery.   Results: The Thermal Stimulation group showed a potential trend for improved recovery stage as measured by Brunnstorm staging for motor recovery of hand as compared to the Mirror therapy group. The Thermal Stimulation group also showed a statistically significant and large improvement in tactile, proprioception and stereognosis score as measured by Revised Nottingham sensory assessment scale whereas Mirror Therapy group showed significant improvement in stereognosis score alone.   Conclusion: Thermal stimulation has more positive effect in the sensorimotor and functional recovery of hand in acute stroke patients with hand impairment within 3 weeks in comparison to Mirror Therapy. Thermal stimulation protocol should be added in the clinical setting of rehabilitation in stroke patients with hand impairment on the basis of the result of this study.