Comparing Unimanual and Bimanual Mirror Therapy for Upper Limb Recovery Post Stroke

Completed

Interventions: Behavioral: Traditional Home Based Exercise Program
Behavioral: Bimanual Home Based Mirror Therapy Program
Behavioral: Unimanual Home Based Mirror Therapy Program

Brief Summary: The purpose of this randomized controlled study is to

1. Examine the feasibility of a home Mirror therapy (MT) program in the NYC metropolitan area;

2. Evaluate the effectiveness of home MT versus traditional home exercise program; and

3. Evaluate the superiority of unimanual or bimanual MT intervention protocols for chronic stroke subjects with moderate hand deficits. Subjects from occupational therapy at the Ambulatory Care Center of NYU Langone Center with a diagnosis of cerebral vascular accident (CVA) or stroke will be divided into three (3) groups:

* Control Group subjects will participate in standard occupational therapy rehabilitation protocol plus a traditional home based exercise program.

* Experimental group 1 subjects will participate in standard rehabilitation protocol plus unimanual home based mirror therapy program

* Experimental group 2 subjects will participate in standard rehabilitation protocol plus bimanual home based mirror therapy program.

Recruitment & Eligibility

Inclusion Criteria

First time unilateral stroke > 3 months post stroke.
Cognitively be able to follow direction
Cognitively be able to consent to participation in research study
Moderate/severe deficits as per the Fugl-Meyer assessment score from 10-50 and the ability to grasp and release a small towel or washcloth.

Exclusion Criteria

Complex medical problems, that would render the subject unable to participate in an extensive home program
History of pre-existing neurological or psychiatric diseases, orthopedic conditions of the upper limbs, or peripheral nerve injuries that render the subject unable to sit or to move either upper limb
Hearing and vision impairments which may impede subjects participation in the home program
Perceptual deficits such as apraxia, neglect, or agnosias as per clinical evaluation which may impede subjects participation in the home program
Botox injection in affected arm/hand within 3 months
Global aphasia that may interfere with understanding instruction for testing or home exercise program.

Arm && Interventions

Group	Intervention	Description
Control Group	Traditional Home Based Exercise Program	Subjects will participate in standard occupational therapy rehabilitation protocol plus a traditional home based exercise program.
Experimental Group 2	Bimanual Home Based Mirror Therapy Program	Subjects will participate in standard rehabilitation protocol plus bimanual home based mirror therapy program.
Experimental Group 1	Unimanual Home Based Mirror Therapy Program	Subjects will participate in standard rehabilitation protocol plus unimanual home based mirror therapy program

Primary Outcome Measures

Name	Time	Method
Grip strength	Baseline to Six (6) Weeks	Grip strength is important to measure as it is correlated with stroke recovery.
Action Research Arm Test (ARAT)	Baseline to Six (6) Weeks	An interview based tool that measures a subject's perceived difficulty with the use of their arm/hands with activities of daily living post-stroke.
Fugl-Meyer Assessment (FMA)	Baseline to Six (6) Weeks	Gold Standard to evaluate and measure recovery in patients with hemiplegia post stroke.
Stroke Impact Scale Version 3.0	Baseline to Six (6) Weeks	A subjective standardized 59-items 8 domain questionnaire assessing health status post-stroke.

Secondary Outcome Measures

Name	Time	Method

Locations (1): New York University School of Medicine
🇺🇸
New York, New York, United States

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