Monday, November 28, 2011
Final reflection
It was interesting to have a go with one of my own arms (right arm) in the mirror box; when I looked in the mirror at the image of left arm my immediate thought was that I was looking at my right arm. I found it very interesting that even knowing the purpose and concept of the mirror box it still was able to trick my brain into thinking that the image of my left arm was my right arm. Through the education and experience I have gained about mirror therapy, I will continue to follow research and see what possibilities mirror therapy could be used for in my future practice.
Research
Two studies that I looked at regarding mirror therapy following a stroke were 1. Systematic review of the effectiveness of mirror therapy in upper extremity function. Written by Ezendam, Bongers & Jannink, 2009; and 2. Mirror therapy improves hand function in sub-acute stroke: a randomized controlled trial.
Article one state its findings as “All studies showed a positive result of mirror therapy. The positive result was based on a combination score given by two neurologists and subjective comments.”(Ezendam, Bongers & Jannink, 2009)
Article two state its findings as “Mirror therapy, in addition to conventional therapy, improved hand function in patients with severe hemiparesis both post-treatment and at six month follow-up.” (Yavuzer et al, 2008)
Both of these studies show that mirror therapy has the potential to be an effective tool used to increase function for people with hemiparesis following a stroke. We also need to be mindful that mirror therapy is a relatively new concept which requires more research to be certain of its effectiveness.
Ezendam, D., Bongers, R. M., & Jannink, M. J. (2009). Systematic review of the effectiveness of mirror therapy in upper extremity function. Disability and Rehabilitation, 31(26), 2135-2149.
Yavuzer, G., Selles, R., Sezer, N., Sütbeyaz, S., Bussmann, J. B., Köseoglu, F., & Atay, M. (2008). Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 393-398.
Article one state its findings as “All studies showed a positive result of mirror therapy. The positive result was based on a combination score given by two neurologists and subjective comments.”(Ezendam, Bongers & Jannink, 2009)
Article two state its findings as “Mirror therapy, in addition to conventional therapy, improved hand function in patients with severe hemiparesis both post-treatment and at six month follow-up.” (Yavuzer et al, 2008)
Both of these studies show that mirror therapy has the potential to be an effective tool used to increase function for people with hemiparesis following a stroke. We also need to be mindful that mirror therapy is a relatively new concept which requires more research to be certain of its effectiveness.
Ezendam, D., Bongers, R. M., & Jannink, M. J. (2009). Systematic review of the effectiveness of mirror therapy in upper extremity function. Disability and Rehabilitation, 31(26), 2135-2149.
Yavuzer, G., Selles, R., Sezer, N., Sütbeyaz, S., Bussmann, J. B., Köseoglu, F., & Atay, M. (2008). Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 393-398.
Sunday, November 27, 2011
Check out this website!
http://www.ireflex.co.uk/mirrorboxtherapy.com/
Above is a fantastic link that has lots of information about mirror box therapy. You can also see what the box looks like and also visit links to research that has been completed.
Above is a fantastic link that has lots of information about mirror box therapy. You can also see what the box looks like and also visit links to research that has been completed.
My Experience
While on my placement I was fortunate to be able to have a look at the mirror therapy box and be able to learn about its use and how it works. I was fortunate to end up with a patient on my caseload that was appropriate to use mirror therapy as part of her rehabilitation programme. This patient had experienced a stroke resulting in right sided hemiplegia and inattention, apraxia, dyspraxia and dressing apraxia.
Before and after completing mirror therapy I assessed the patient’s functional ability of her right arm (affected arm). In comparing the two assessments the patient had increased her functional ability of her right hand. It surprised me how much the clients function changed with only one session. During the session when the patient’s affected right arm was placed within the box the patient had no active movement of the arm so was passively moved by myself.
This opportunity enabled me to experience on some of the strengths and limitations of the mirror box. During the mirror box intervention I observed ideomotor apraxia as a symptom of my patients following her stroke. Ideomotor apraxia is “the inability to imitate gestures or perform a purposeful motor task on command even though the patient fully understands the idea or concept of the task” (Zoltan, 1996) the patient’s symptom of ideomotor apraxia made the mirror box therapy very hard to facilitate as she had difficulty in imitating the movements requested.
Overall I feel that mirror therapy would be difficult to facilitate for this patient but also be very successful.
Zoltan, B. (1996). Vision, perception, and cognition: a manual for the evaluation and treatment of the neurologically impaired adult (3rd ed., pp. 53-68). N.p.: Slack Incorporated.
Before and after completing mirror therapy I assessed the patient’s functional ability of her right arm (affected arm). In comparing the two assessments the patient had increased her functional ability of her right hand. It surprised me how much the clients function changed with only one session. During the session when the patient’s affected right arm was placed within the box the patient had no active movement of the arm so was passively moved by myself.
This opportunity enabled me to experience on some of the strengths and limitations of the mirror box. During the mirror box intervention I observed ideomotor apraxia as a symptom of my patients following her stroke. Ideomotor apraxia is “the inability to imitate gestures or perform a purposeful motor task on command even though the patient fully understands the idea or concept of the task” (Zoltan, 1996) the patient’s symptom of ideomotor apraxia made the mirror box therapy very hard to facilitate as she had difficulty in imitating the movements requested.
Overall I feel that mirror therapy would be difficult to facilitate for this patient but also be very successful.
Zoltan, B. (1996). Vision, perception, and cognition: a manual for the evaluation and treatment of the neurologically impaired adult (3rd ed., pp. 53-68). N.p.: Slack Incorporated.
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