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Meta-Analysis
. 2023 Nov 16;13(1):20018.
doi: 10.1038/s41598-023-47272-9.

Mirror therapy combined with neuromuscular electrical stimulation for poststroke lower extremity motor function recovery: a systematic review and meta-analysis

Zhen-Han Oh  1 , Chia-Hung Liu  1   2 , Chih-Wei Hsu  3 , Tsan-Hon Liou  3   4 , Reuben Escorpizo  5   6 , Hung-Chou Chen  7   8   9
Affiliations
Meta-Analysis

Mirror therapy combined with neuromuscular electrical stimulation for poststroke lower extremity motor function recovery: a systematic review and meta-analysis

Zhen-Han Oh et al. Sci Rep. .

Abstract

The combination of mirror therapy (MT) and neuromuscular electrical stimulation (NMES) has been devised as an intervention method in stroke rehabilitation; however, few studies have investigated its efficacy in lower extremity motor function recovery. In this systematic review and meta-analysis, we examined the effectiveness of combined MT and NMES therapy in improving poststroke walking speed, spasticity, balance and other gait parameters. Randomized controlled trials (RCTs) were selected from PubMed, Cochrane Library, EMBASE, and Scopus databases. In total, six RCTs which involving 181 participants were included. Our findings indicate that MT combined with NMES elicits greater improvement relative to control group in walking speed (SMD = 0.67, 95% confidence interval [CI] 0.26-1.07, P = 0.001), Berg Balance Scale (SMD = 0.72; 95% CI 0.31-1.13; P = 0.0007), cadence (SMD = 0.59, 95% CI 0.02-1.16, P = 0.04), step length (SMD = 0.94, 95% CI 0.35-1.53, P = 0.002), and stride length (SMD = 0.95, 95% CI 0.36-1.54, P = 0.002) but not in modified Ashworth scale (SMD = - 0.40, 95% CI - 1.05 to 0.26, P = 0.23). Our findings suggest that MT combined with NMES may be a suitable supplemental intervention to conventional therapy in stroke survivors.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection process. n, number.
Figure 2
Figure 2
Walking speed. MT, mirror therapy; NMES, neuromuscular electrical stimulation; 95% CI, 95% confidence interval.
Figure 3
Figure 3
Berg balance scale. MT, mirror therapy; NMES, neuromuscular electrical stimulation; 95% CI, 95% confidence interval.
Figure 4
Figure 4
Modified Ashworth scale. MT, mirror therapy; NMES, neuromuscular electrical stimulation; 95% CI, 95% confidence interval.
Figure 5
Figure 5
Gait parameters. MT, mirror therapy; NMES, neuromuscular electrical stimulation; 95% CI, 95% confidence interval.
See this image and copyright information in PMC

References

    1. Campbell BCV, Khatri P. Stroke. Lancet. 2020;396:129–142. doi: 10.1016/S0140-6736(20)31179-X. - DOI - PubMed
    1. Donkor ES. Stroke in the 21(st) century: A snapshot of the burden, epidemiology, and quality of life. Stroke Res. Treat. 2018;2018:3238165. doi: 10.1155/2018/3238165. - DOI - PMC - PubMed
    1. Collaborators GBDS. Global, regional, and national burden of stroke, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:439–458. doi: 10.1016/S1474-4422(19)30034-1. - DOI - PMC - PubMed
    1. Bernspång B, Asplund K, Eriksson S, Fugl-Meyer AR. Motor and perceptual impairments in acute stroke patients: Effects on self-care ability. Stroke. 1987;18:1081–1086. doi: 10.1161/01.str.18.6.1081. - DOI - PubMed
    1. da Cunha Jr IT, et al. Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: A randomized controlled pilot study. Arch. Phys. Med. Rehabil. 2002;83:1258–1265. doi: 10.1053/apmr.2002.34267. - DOI - PubMed