The Effect of Mirror Therapy on Spasticity in Adult Patients With Stroke: a Systematic Review and Meta-Analysis

Abstract

Objective This study aims to investigate the effects of Mirror Therapy (MT) on spasticity and related parameters in stroke patients Methods A systematic review was performed in databases PubMed, Web of Science, Science Direct, Cochrane, and Scopus databases for published RCTs (Randomized Controlled Trials) from the date of each database's inception to May 2021. Modified Ashworth Scale (MAS) in adult patients with stroke compared to conventional therapy, sham, and additional therapy control were included. Physiotherapy Evidence Database Scale was used to assess the methodological quality of each study. Results The overall effect of MT on MAS was statistically significant and beneficial when studies were analyzed in terms of both upper and lower extremities (p < 0.001). MT demonstrated a large and beneficial overall effect on the Brunnstrom Assessment compared to conventional therapy (p < 0.001). The overall impact of MT on Fugl-Meyer Assessment (FMA) was large and statistically significant (p < 0.001). However, a meta-analysis of three studies using the 10-meter walk test showed that the overall effect of MT was not statistically significant (p = 0.258). Conclusion This systematic review and meta-analysis demonstrates reductions in upper and lower extremity spasticity and improved motor recovery with MT, both isolated and combined with other treatments, in adults with stroke. PROSPERO registration number CRD42021255154.