This study was conducted to determine whether mirror therapy has an additive effect on cross-education of the strength of neuromuscular electrical stimulation (NMES) in patients with hemiplegia. As an outcome measure, the ankle dorsiflexion strength of hemiplegic patients was measured.
A total of 29 patients, 7 women, and 22 men were included according to the inclusion and exclusion criteria. The patients were randomly assigned to the control group (n = 14) and the Mirror group (n = 15). Five sessions of neuromuscular electrical stimulation, unaffected side ankle dorsiflexors were applied to the patients in both groups. In addition to the NMES, mirror therapy was applied to the experimental group simultaneously with NMES. Before and after treatment, both ankle dorsiflexor strength was measured with a force sensor. For force measurements, a force transducer (FC2211-0000-0100-L Compression Load Cell, TE Connectivity company, France) was used. Force transducer signals were received with a data acquisition device (POWERLAB® data acquisition system ADInstruments, Oxford, UK) and evaluated offline on the computer. The measurement values were expressed in kilogram.force (kg.f) and this value was normalized according to body weight.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
29
Combined Mirror and NMES therapy
Only NMES therapy
Istanbul Physical Medicine Rehabilitation Training & Research Hospital
Istanbul, Turkey (Türkiye)
Change of ankle dorsiflexor isometric muscle strength
Force transducer used for measuring maximum voluntary ankle dorsiflexion force. The force unit is kilogram.force
Time frame: Change from Baseline muscle strength at 6 days
Change of Lower Extremity Brunnstrom score
It evaluates the developmental stages of synergy patterns, muscle tone and isolated movements of the patients in the lower extremities. Patients are categorized between Stage-1 and 6. Stage 1: Flaccidity; Stage 6: Spasticity Disappears and Coordination Reappears
Time frame: Change from Baseline Brunnstrom score at 6 days
Change of Modified Ashworth Scale score
Modified Ashworth Scale was used for assessment spasticity. Modified Ashworth Scale scores are varied between 0 and 4: 0 points, no increase in muscle tone; 4 points indicate spasticity with a degree of rigidity.
Time frame: Change from Baseline Modified Ashworth Scale score at 6 days
Change of Functional Ambulation Scale score
The Functional Ambulation Classification (FAC) is a method for classifying mobility. The FAC has six categories ranging from 0 (non-functional ambulation) to 5 (independent).
Time frame: Change from Baseline Functional Ambulation Scale score at 6 days
Change of Timed Up and Go Test score
It is a test that evaluates the patient's static and dynamic balance, mobility and walking ability. The test's score is the time in seconds it takes the subject takes to complete the test.
Time frame: Change from Baseline Timed Up and Go Test score at 6 days
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