The Observation Of Curative Effect Of Mirror Visual Feedback Onimproving Upper Limb Function And Activities Of Daily Living Of Stoke Survivors

Stroke is a cerebrovascular disease with a high incidence and is easy to produce disability. As the improvement of people’s living standard, the dietary habits, work and rest time and the amount of exercise have changed. Intake of high-calorie diet, increased office jobs, reductive physical activity, excess mental labour and many other factors make modern people suffer from increased risk of cerebrovascular disease. The age-standardized incidence rate in different regions of China is(260 to 719)/10 million. More than 50% of stroke patients are left with long-term or permanent upper limb dysfunction. Neurological rehabilitation workers have been working to find simple and effective measures to promote recovering the function of hemiplegic limb to the best advantage.In recent years, the curative effect of mirror visual feedback on improving limb function of stoke survivors has been becoming the focus in neurological rehabilitation.Objective:To explore the effect of mirror visual feedback(MVF) on upper limb function and activities of daily living(ADL) after stroke.Methods:Sixty-one cases of cerebral apoplexy hemiplegia patients were divided according to random number table method into treatment group(including 31 cases)which received mirror visual feedback training for 15 minutes per time, 2 times per day,6 days per week and control group(including 30 cases) which received the same training but with a panel covering the mirror. All the patients received the conventional rehabilitation program in the rest of the day. The Brunnstrom motor recovery stage(the part of the upper limb and the hand), Fugl-Meyer motor assessment(upper limb)(FMA-U), modified Barthel index(MBI), self-care items of the functional independence measure(self-care items of the FIM)and modified Ashworth scale(MAS)were used to evaluate the function of upper limb and activities of daily living for both groups of patients before and at the end of the 4 weeks of training.Results:In terms of the Brunnstrom motor recovery stage, before the intervention, in the treatment group, the number of cases from stageⅠtoⅥ about the upper limb is 10,5,8,5,3,0 respectively and about the hand is 10,5,8,5,3,0 respectively. In the control group, that is 4,9,8,5,4,0 respectively about the upper limb, and 10,5,8,5,3,0 respectively about the hand. After 4 weeks of training, in the treatment group, the number of cases from stageⅠtoⅥ about the upper limb is 0,0,4,12,12,3 respectively and about the hand is 0,3,12,6,9,1 respectively. In the control group, that is 0,6,11,8,5,0 respectively about the upper limb, and 5,10,6,5,4,0 respectively about the hand.In terms of the FMA-U, after 4 weeks of training, the score of the treatment group is 39.42±17.378 which increased from 29.45±17.940 primitively and the score of the control group is 31.80±16.906 which increased from 25.60±17.694 primitively.In terms of the MBI, after 4 weeks of training, the score of the treatment group is 82.84±14.404 which increased from 56.55±22.598 primitively and the score of the control group is 70.87±18.515 which increased from 54.37±24.699 primitively.In terms of the self-care items of the FIM, after 4 weeks of training, the score of the treatment group is 27.68±6.258 which increased from 17.35±6.780 primitively and the score of the control group is 24.50±6.479 which increased from 18.17±7.245 primitively.In terms of the MAS, before the intervention, there are 18 patients in the treatment group whose upper limb muscle is spasmodical which consists of 10 cases in gradeⅠ,6 inⅠ+ and 2 inⅡ,and 15 patients in the control group which consists of 8 cases in gradeⅠ,6 inⅠ+ and 1 inⅡ. after 4 weeks of training, there are 15 patients in the treatment group whose upper limb muscle is spasmodical which consists of 11 cases in gradeⅠ, 2 inⅠ+ and 2 inⅡ,and 14 patients in the control group which consists of 10 cases in gradeⅠ, 3 inⅠ+ and 1 inⅡ.Before the intervention, there was no significant difference between the two groups in terms of all the assessments(P>0.05).After 4 weeks of training, the Brunnstrom motor recovery stage(the part of the upper limb and the hand),grades in FMA-U,MBI and the self-care items of the FIM of both groups had improved significantly(P<0.01).The improvement was significantly greater in the treatment group than the control group in terms of the Brunnstrom motor recovery stage(the part of the upper limb and the hand),FMA-U, MBI and the self-care items of the FIM scores(P<0.05).In terms of the MAS, there was no significantly difference in all the patients before and after 4 weeks training(P>0.05).Conclusion:1 In this study, the improvement was significantly greater in the treatment group than the control group in terms of the Brunnstrom motor recovery stage(the part of the upper limb and the hand),FMA-U, MBI and the self-care items of the FIM scores. Accordingly,MVF combined with conventional rehabilitation program can promote the recovery of upper limb motor function and the activities of daily living of the hemiplegic patients after stroke.2 In this study, MVF was conducted 15 minutes at a time, 2 times per day, and 6 days per week. The result of this study shows the effect of this program.3 In this study, we have not found the effect of MVF in easing the spasm of upper limb of the patients after stroke. Accordingly, it is appropriate to apply MVF as an assistant therapy, as to easing the spasm, it is necessary to adopt other effective measures.