Systematic review on the effectiveness of mirror therapy in training upper limb hemiparesis after stroke

Objective/Background: This study aims to review the current evidence on effectiveness of mirror therapy (MT) in improving motor function of the hemiplegic upper limb (UL) among the adult stroke population in the last 12 years. Methods: A systematic review of studies published in English from 1999 to 2011, retrieved from four electronic databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Sage Online, and ScienceDirect, was performed. Only articles focusing on the effects of MT to train UL motor function were included. The methodological quality of the studies was appraised based on the design and Physiotherapy Evidence Database Scale. Results: Of the 1,129 articles, nine (six randomised controlled trials and three case reports) were reviewed. The majority of the studies were heterogeneous in design. The review indicated that the strength of current evidence for the use of MT with the stroke population is moderate and seemed to benefit participants with subacute stroke. Little is known about its long-term sustainability, the right target group of the stroke population, and the optimal time to start intervention. Conclusion: More research is needed to determine the optimal dose of therapy, optimal time to start this intervention, and the right target group. Accordingly, no firm conclusions can now be drawn on the effectiveness of MT until more evidence is present.