Enhancing Upper Limb Performance in Sub-acute Stroke Patients: A Systematic Review of Combined Modified Constraint-Induced Movement Therapy and Mirror Therapy Interventions

Objective: Sub-acute stroke is a common condition that often results in upper limb impairments. This systematic review aims to evaluate the effectiveness of combined modified constraint-induced movement therapy (mCIMT) and mirror therapy on upper limb performance in patients with sub-acute stroke. The review also aimed to identify gaps in the existing literature and provide recommendations for future research. Methods: A comprehensive search was conducted on electronic databases, including PubMed, Google Scholar, ResearchGate, and AJOT. Studies published between 2010 and 2022 were included in the review. Qualitative studies that investigated the effects of combined mCIMT and mirror therapy in patients with sub-acute stroke were included. The PRISMA flow diagram was utilized to track the study selection process. Two independent reviewers assessed the eligibility of the studies and extracted relevant data using predefined criteria. Results: Out of the initial 250 articles, 10 studies met the inclusion criteria and were included in the review. Published between 2010 and 2022, these studies utilized various research designs, including quasi-experimental studies, randomized controlled trials, and pilot studies. The majority of the studies were conducted in hospital settings and involved patients with sub-acute stroke. The findings of the included studies suggest that combined mCIMT and mirror therapy have positive effects on hand functions, motor recovery, functional outcomes, and activities of daily living in patients with sub-acute stroke. Conclusion: This systematic review provides evidence supporting the effectiveness of combined mCIMT and mirror therapy in improving upper limb performance in patients with sub-acute stroke. These interventions have the potential to enhance motor recovery and functional outcomes in this population. However, further research is needed to determine the optimal duration, intensity, and timing of these interventions. Standardized outcome measures and larger sample sizes should be considered in future studies to strengthen the evidence base.