scholarly journals Mirror Therapy and Action Observation Therapy to Increase the Affected Upper Limb Functionality in Children with Hemiplegia: A Randomized Controlled Trial Protocol

2021 ◽  
Vol 18 (3) ◽  
pp. 1051
Author(s):  
Rocío Palomo-Carrión ◽  
Juan Carlos Zuil-Escobar ◽  
Myriam Cabrera-Guerra ◽  
Paloma Barreda-Martínez ◽  
Carmen Belén Martínez-Cepa
Keyword(s):  
Randomized Controlled Trial ◽  
Upper Limb ◽  
Action Observation ◽  
Controlled Trial ◽  
Hand Function ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
End Of Treatment ◽  
Mirror Box

The movements of the affected upper limb in infantile hemiplegia are slower and clumsy. This leads to a decrease in the use of the affected hand. The visual effect obtained using the mirror box and the observation of actions in another individual can activate the same structural neuronal cells responsible for the execution of these actions. This research will study the affected upper limb functionality in hemiplegia infantile from 6 to 12 years old after the application of two intervention protocols: observation action therapy and mirror therapy combined with observation action therapy. Children with a diagnose of congenital infantile hemiplegia will be recruited to participate in a randomized controlled trial with two intervention protocols during four weeks (1 h per/day; 5 sessions per/week): Mirror Therapy Action Observation (MTAO) or Action Observation Therapy (AOT). The study variables will be: spontaneous use, measured with the Assisting Hand Assessment (AHA); manual ability measured with the Jebsen Taylor Hand Function Test (JTHFT); surface electromyography of the flexors and extensors muscles of the wrist and grasp strength through a grip dynamometer. Four assessments will be performed: At baseline situation, at the end of treatment, 3 and 6 months after treatment (follow-up assessments). This study will study the effects of these therapies on the use of the affected upper limb in children with hemiplegia.

scholarly journals Pilot Randomized Controlled Trial of Web-Delivered Acceptance and Commitment Therapy Versus Smokefree.gov for Smokers With Bipolar Disorder

2019 ◽  
Vol 22 (9) ◽  
pp. 1543-1552 ◽  
Author(s):  
Jaimee L Heffner ◽  
Megan M Kelly ◽  
Jeanette Waxmonsky ◽  
Kristin Mattocks ◽  
Edit Serfozo ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Trial Design ◽  
Nicotine Patch ◽  
Controlled Trial ◽  
Web Based ◽  
Randomized Controlled ◽  
Acceptance And Commitment ◽  
End Of Treatment ◽  
Pilot Randomized Controlled Trial

Abstract Introduction Smokers with bipolar disorder (BD) are less successful at quitting than the general population. In this study, we evaluated in a pilot randomized controlled trial a novel, targeted, web-based intervention for smokers with BD based on acceptance and commitment therapy (ACT) and designed for reach and disseminability. Aims and Methods Daily smokers (n = 51) with bipolar I or II disorder were recruited from four US sites and randomly assigned to one of two web-based smoking cessation interventions—ACT-based WebQuit Plus (n = 25) or Smokefree.gov (n = 26) over a 10-week treatment period. All participants received nicotine patch for 8 weeks. Key outcomes were trial design feasibility, intervention acceptability, and cessation at end of treatment and 1-month follow-up. Results We screened 119 to enroll 51 participants (target sample size = 60) over 24 months. The most common reason for ineligibility was the inability to attend study appointments. Retention was 73% at end of treatment and 80% at follow-up, with no differences by arm. The mean number of logins was twice as high for WebQuit Plus (10.3 vs. 5.3). The usefulness of program skills was rated higher for WebQuit Plus (75% vs. 29%). Biochemically confirmed, 7-day abstinence at end of treatment was 12% in WebQuit Plus versus 8% in Smokefree.gov (odds ratio = 1.46, 95% confidence interval = 0.21 to 9.97). At follow-up, abstinence rates were 8% in both arms. Conclusions Trial design produced favorable retention rates, although alternative recruitment methods will be needed for a larger trial. At end of treatment, acceptability and estimated effect size of WebQuit Plus relative to Smokefree.gov were promising and support continued program refinement and evaluation. Implications In this first randomized controlled trial of a targeted intervention for smokers with BD, we found that the ACT-based WebQuit Plus intervention, delivered in combination with the nicotine patch, had promising acceptability and cessation outcomes relative to Smokefree.gov. The observed signals for acceptability and cessation suggest that the WebQuit Plus program should be refined based on participant feedback and evaluated in a larger trial. Feasibility findings from this study also provide direction for refining trial procedures to enhance the recruitment of smokers with BD.

Robot-assisted gait training is not superior to intensive overground walking in multiple sclerosis with severe disability (the RAGTIME study): A randomized controlled trial

2019 ◽  
Vol 26 (6) ◽  
pp. 716-724 ◽  
Author(s):  
Sofia Straudi ◽  
Fabio Manfredini ◽  
Nicola Lamberti ◽  
Carlotta Martinuzzi ◽  
Elisa Maietti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Randomized Controlled Trial ◽  
Gait Speed ◽  
Controlled Trial ◽  
Gait Training ◽  
Overground Walking ◽  
Robot Assisted ◽  
Randomized Controlled ◽  
End Of Treatment

Background: Rehabilitation may attenuate the impact on mobility of patients with progressive multiple sclerosis (MS) and severe gait disabilities. Objective: In this randomized controlled trial, we compared robot-assisted gait training (RAGT) with conventional therapy (CT) in terms of gait speed, mobility, balance, fatigue and quality of life (QoL). Methods: Seventy-two patients with MS (expanded disability status scale score 6.0–7.0) were randomized to receive 12 training sessions over a 4-week period of RAGT ( n = 36) or overground walking therapy ( n = 36). The primary outcome was gait speed, assessed by the timed 25-foot walk test. Secondary outcome measures were walking endurance, balance, depression, fatigue and QoL. Tests were performed at baseline, intermediate, at the end of treatment and at a 3-month follow-up. Results: Sixty-six patients completed the treatments. At the end of treatment with respect to baseline, both groups significantly improved gait speed ( p < 0.001) and most secondary outcomes without between-group differences. Outcome values returned to baseline at follow-up. Conclusions: RAGT was not superior to CT in improving gait speed in patients with progressive MS and severe gait disabilities where a positive, even transitory, effect of rehabilitation was observed.

No evidence of effectiveness of mirror therapy early after stroke: an assessor-blinded randomized controlled trial

2019 ◽  
Vol 33 (5) ◽  
pp. 885-893 ◽  
Author(s):  
Paola Antoniotti ◽  
Laura Veronelli ◽  
Antonio Caronni ◽  
Alessia Monti ◽  
Evdoxia Aristidou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Upper Limb ◽  
Controlled Trial ◽  
Intervention Group ◽  
Functional Independence ◽  
Control Group ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Flexion Extension

Objective: The aim of this study was to investigate the efficacy of mirror therapy on upper-limb recovery in early post-stroke patients. Design: Assessor-blinded randomized controlled trial. Setting: Inpatient rehabilitation clinic. Subjects: A total of 40 patients with upper-limb impairment due to a first-ever ischaemic or haemorrhagic stroke, within four weeks from the cerebrovascular accident. Intervention: The intervention group received mirror therapy, while the control group received sham therapy. During mirror therapy, patients’ sound hand was reflected by a mirror. During sham therapy, an opaque surface replaced the mirror-reflecting surface. Both the mirror therapy and sham therapy groups practised their sound hand with exercises, ranging from the simple elbow flexion–extension to complex tasks (e.g. reaching and grasping). Mirror therapy and sham therapy were added to conventional rehabilitation. Main measures: Primary outcome includes Fugl–Meyer upper extremity scale. Secondary outcomes include action research arm test (ARAT) and functional independence measure (FIM) scale. Outcomes were measured at the beginning (T0) and end (T1) of the treatment. Results: At baseline, both groups (sham therapy vs. mirror therapy; mean (SD)) were comparable for Fugl–Meyer (30.9 (23.9) vs. 28.5 (21.8)), ARAT (25.1 (25.5) vs. 23.5 (24)) and FIM (71.0 (20.6) vs. 72.9 (17.8)) scores. At the end of the treatment, both groups significantly improved in the Fugl–Meyer (40.6 (21.3) vs. 38.3 (23.4)), ARAT (31.9 (23.0) vs. 30 (24.1)) and FIM (100.3 (21.9) vs. 99.4 (22.6)) scores. However, at T1, no significant difference was observed between the sham therapy and mirror therapy groups, neither for the Fugl–Meyer, nor for ARAT and FIM scores. Conclusion: Compared with sham therapy, mirror therapy did not add additional benefit to upper-limb recovery early after stroke.

scholarly journals Cognitive–behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis

2015 ◽  
Vol 45 (13) ◽  
pp. 2793-2804 ◽  
Author(s):  
S. Young ◽  
M. Khondoker ◽  
B. Emilsson ◽  
J. F. Sigurdsson ◽  
F. Philipp-Wiegmann ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Randomized Controlled ◽  
Cognitive Behavioural ◽  
End Of Treatment ◽  
Over Time

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by high rates of co-morbid psychopathology. Randomized controlled trials of multimodal interventions, combining pharmacological and psychological treatments, have shown a robust treatment effect for ADHD symptoms but outcomes for co-morbid symptoms have been mixed. This may be accounted for by the type of intervention selected and/or by methodological problems including lack of follow-up and low power. The current study addressed these limitations in a parallel-group randomized controlled trial conducted in Iceland.MethodA total of 95 adult ADHD patients who were already being treated with medication (MED) were randomly assigned to receive treatment as usual (TAU/MED) or 15 sessions of cognitive–behavioural therapy (CBT/MED) using theR&R2ADHDintervention which employs both group and individual modalities. Primary measures of ADHD symptoms and severity of illness, and secondary measures of anxiety, depression and quality of life were given at baseline, end of treatment and 3-month follow-up. Primary outcomes were rated by clinicians blind to treatment condition assignment.ResultsCBT/MED showed overall (combined outcome at end of treatment and 3-month follow-up) significantly greater reduction in primary outcomes for clinician-rated and self-rated ADHD symptoms. Treatment effect of primary outcomes was maintained at follow-up, which suggests robust and lasting findings. In contrast to the primary outcomes, the secondary outcomes showed significant improvement over time.ConclusionsThe study provides evidence for the effectiveness ofR&R2ADHDand demonstrates that there are differential effects over time for ADHD symptomsversusco-morbid problems, the latter taking longer to show positive effects.

Mirror Therapy Improves Hand Function in Subacute Stroke: A Randomized Controlled Trial

2008 ◽  
Vol 89 (3) ◽  
pp. 393-398 ◽  
Author(s):  
Gunes Yavuzer ◽  
Ruud Selles ◽  
Nebahat Sezer ◽  
Serap Sütbeyaz ◽  
Johannes B. Bussmann ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Hand Function ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
Subacute Stroke

scholarly journals Effects of Free Range-of-Motion Upper Limb Exercise Based on Mirror Therapy on Shoulder Function in Patients After Breast Cancer Surgery: Study Protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Ru Zhen Yuan ◽  
Kun Peng Li ◽  
Xiao Lin Wei ◽  
Wei Zheng ◽  
Yi Ye ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Range Of Motion ◽  
Upper Limb ◽  
Controlled Trial ◽  
Shoulder Function ◽  
Mirror Therapy ◽  
Free Range ◽  
Randomized Controlled ◽  
Limb Exercise

Abstract Background Shoulder function complications are common after surgery for breast cancer. Quite a few survivors still reported a limited shoulder range of motion, even though the free range-of-motion upper limb exercise is helpful to restore shoulder function post-operatively. Mirror therapy(MT) is a classical and effective rehabilitation technique to recover motor and sensory function for limbs, in addition, studies have reported that MT has the influence on patients with shoulder functional dysfunction including increasing shoulder range of motion, improving shoulder function scores, and decreasing pain scores. Here we describe a protocol of a randomized controlled trial to explore if the free range-of-motion upper limb exercise based on mirror therapy has efficacy on shoulder function in breast cancer survivors after surgery.Methods/design This is a prospective, single-blind, two-arm randomized controlled trial. An estimated 70 participants will be randomly allocated to 1) MT group or 2) control group. The participants in the control group receive free range-of-motion upper limb exercise, and participants in the MT group will engages in free range-of-motion upper limb exercise based on mirror therapy. The intervention will start from the first day after surgery and will be completde at 8 weeks after surgery. Primary outcomes in this protocol is shoulder range of motion(ROM), while the Constant-Murley Score(CMS), Disability of arm, shoulder, and hand Questionnaire (DASH), Tampa Scale of Kinesiophobia (13-item TSK), Visual Analogue Scale(VAS), grip strength, arm circumference, and lypmphedema are secondary outcomes. Assessment will be conducted before allocation(baseline) and at 2 weeks, 4 weeks, and 8 weeks after surgery.Discussion Based on results that mirror therapy has influence on shoulder function immediately after intervention in patients without nerve injury, this randomized controlled trial is the first study to observe the efficacy of mirror therapy on shoulder function after a long time intervention in breast cancer survivors. We look forward the innovation of this study for both breast cancer rehabilitation and mirror therapy. Trial registration Chinese Clinical Trial Registry (ChiCTR): ChiCTR 2000033080. Registered on 19 May 2020, http://www.chictr.org.cn/searchproj.aspx.

Effects of mirror therapy on motor aphasia after acute cerebral infarction: A randomized controlled trial

2021 ◽  
pp. 1-15
Author(s):  
Qingmei Chen ◽  
Wenjun Shen ◽  
Haiwei Sun ◽  
Dan Shen ◽  
Xiuying Cai ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Functional Connectivity ◽  
Cerebral Infarction ◽  
Controlled Trial ◽  
Test Group ◽  
Control Group ◽  
Mirror Therapy ◽  
Motor Aphasia ◽  
Randomized Controlled

BACKGROUND: Mirror therapy (MT) has proven to be beneficial for treating patients suffering from motor aphasia after stroke. However, the impacts of MT on neuroplasticity remain unexplored. OBJECTIVE: In this paper we conducted a randomized controlled trial to evaluate the treatment using the MT on motor aphasia following acute cerebral infarction. METHODS: We randomly assigned 30 patients into test and control groups, with test group patients treated with MT, whereas control group patients were treated with sham MT. At 24 hours prior to and after the intervention, we obtained functional magnetic resonance imaging (fMRI) data from study subjects. At baseline, after treatment and 12-week follow-up, we additionally evaluated patients with the Modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), and the aphasia quotient (AQ) in the western aphasia test. RESULTS: After 2 weeks of treatment, the test group demonstrated significant improvements in AQ values, naming, repetition, spontaneous speech, and mRS scores compared to the control group (P <  0.05). Furthermore, in the follow-up time point (12 weeks), we found that the test group exhibited significantly better NIHSS scores and AQ evaluation indicators than the control group (P <  0.05). Specifically, the fMRI study shows that functional connectivity significantly improved in test group patients mainly among frontal, temporal, and parietal lobes of the left hemisphere with each other than controls group. Meanwhile, we found significantly enhanced functional connectivity with the hippocampus (P <  0.01). CONCLUSIONS: Our results indicate that the MT can expedite the recovery of language function during the early phases of stroke recovery. These findings may elucidate the underlying mechanism of MT and the application of this therapy as an adjunct rehabilitation technique in language recovery.

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