Effect of Mirror Therapy on Unilateral Neglect for Patients After Stroke

Twenty-one subacute inpatients with left unilateral neglect after right-hemispheric stroke, recruited from 2 hospitals - Hong Kong and Guangzhou, in 1 and a half years, were randomly assigned to three groups; mirror therapy, sham therapy (in the form of a transparent glass wall), and control (covered mirror). The treatment programme for all groups consisted of 12 sessions (4 per week for 3 weeks) movement practice for the hemiplegic arm involved 5 table-top tasks graded according to the severity of patients' arm impairments. Blinded assessments were administered at baseline, 3-week postintervention, and 3-week follow-up upon completion of training.

Inclusion criteria

• ischemic or hemorrhagic stroke, confirmed by medical diagnoses compatible with a unilateral right lesion involvement (i.e. left hemiplegic), exhibited left visual field inattention or unilateral neglect by obtaining a total score of star cancellation subtest in the conventional battery of the Behavioural Inattention Test ≤ 51 (out of 54);
• stroke with onset of neurological condition ≤ 6 months previously;
• have normal or corrected-to-normal visual acuity better than 20/60 (6/18) in the better eye;
• with hemiplegic upper extremity functional levels 3-7 as rated by Functional Test for the Hemiplegic Upper Extremity and is able to move against gravity;
• ability to understand and follow simple verbal instructions, with Mini-mental State Examination ≥ 21;
• ability to participate in a therapy session lasting at least 30 minutes;
• consent to participant in the study

Exclusion criteria

• prior neurological or psychiatric disorders;
• severe spasticity (Modified Ashworth Scale >3) over paretic arm;
• history of recent Botox injection or acupuncture to the paretic arm within the past three months;
• participation in another clinical study elsewhere apart from the study site during recruitment