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Phase II pragmatic randomized controlled trial of patient-led therapies mMirror therapy and lower-limb exercises) during inpatient stroke rehabilitation

Tyson, Sarah; Wilkinson, Jack; Thomas, Nessa; Selles, Ruud; McCabe, Candy; Tyrrell, Pippa; Vail, Andy

Phase II pragmatic randomized controlled trial of patient-led therapies mMirror therapy and lower-limb exercises) during inpatient stroke rehabilitation Thumbnail


Authors

Sarah Tyson

Jack Wilkinson

Nessa Thomas

Ruud Selles

Candy McCabe Candy.Mccabe@uwe.ac.uk
Professor of Clinical Research and Practice

Pippa Tyrrell

Andy Vail



Abstract

© American Society of Neurorehabilitation. Background and objective. Patient-led therapy has the potential to increase the amount of therapy patients undertake during stroke rehabilitation and to enhance recovery. Our objective was to assess the feasibility and acceptability of 2 patient-led therapies during the acute stages of stroke care: mirror therapy for the upper limb and lower-limb exercises for the lower limb. Methods. This was a blind assessed, multicenter, pragmatic randomized controlled trial of patient-led upper-limb mirror therapy and patient-led lower leg exercises. Stroke survivors with upper and lower limb limitations, undergoing inpatient rehabilitation and able to consent were recruited at least 1 week poststroke. Results. Both interventions proved feasible, with >90% retention. No serious adverse events were reported. Both groups did less therapy than recommended; typically 5 to 15 minutes for 7 days or less. Participants receiving mirror therapy (n = 63) tended to do less practice than those doing lower-limb exercises (n = 31). Those with neglect did 69% less mirror therapy than those without (P =.02), which was not observed in the exercise group. Observed between-group differences were modest but neglect, upper-limb strength, and dexterity showed some improvement in the mirror therapy group. No changes were seen in the lower-limb group. Conclusions. Both patient-led mirror therapy and lower-limb exercises during inpatient stroke care are safe, feasible, and acceptable and warrant further investigation. Practice for 5 to 15 minutes for 7 days is a realistic prescription unless strategies to enhance adherence are included.

Citation

Tyson, S., Wilkinson, J., Thomas, N., Selles, R., McCabe, C., Tyrrell, P., & Vail, A. (2015). Phase II pragmatic randomized controlled trial of patient-led therapies mMirror therapy and lower-limb exercises) during inpatient stroke rehabilitation. Neurorehabilitation and Neural Repair, 29(9), 818-826. https://doi.org/10.1177/1545968314565513

Journal Article Type Article
Acceptance Date Jan 9, 2015
Online Publication Date Jan 9, 2015
Publication Date Oct 1, 2015
Publicly Available Date Mar 29, 2024
Journal Neurorehabilitation and Neural Repair
Print ISSN 1545-9683
Electronic ISSN 1552-6844
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 29
Issue 9
Pages 818-826
DOI https://doi.org/10.1177/1545968314565513
Keywords stroke, patient-led, mirror therapy, exercise
Public URL https://uwe-repository.worktribe.com/output/805239
Publisher URL http://dx.doi.org/10.1177/1545968314565513

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