Evaluation of Mirror Therapy for Upper Limb Rehabilitation in Stroke

2013 ◽  
Vol 24 (3) ◽  
pp. 63-69 ◽  
Author(s):  
Laisram Nonica ◽  
Muzaffar Tufail ◽  
RK Wadhwa ◽  
Borah Diganta ◽  
SY Kothari
Keyword(s):  
Upper Extremity ◽  
Tertiary Care ◽  
Self Care ◽  
Motor Recovery ◽  
Control Group ◽  
Care Hospital ◽  
Mirror Therapy ◽  
Treatment Protocols ◽  
Upper Limb Rehabilitation ◽  
Significant Difference

Abstract Trials have shown modest clinical improvement in disabilities after stroke with the use of different techniques; however most of the treatment protocols for the paretic upper extremity are either expensive or labour intensive, which makes the provision of intensive treatment for many patients difficult. It has been suggested that mirror therapy is a simple, inexpensive and, most importantly patient-directed treatment that may improve upper extremity function. A prospective randomised case control study was done on 60 patients of both the sexes in the age group of 19 to 82 years having stroke for the first time. This study was conducted in the Department of Physical Medicine and Rehabilitation of a tertiary care hospital. All the patients who fulfilled the criteria were enrolled for study; patients were randomly allotted to the study or control group. Study group was given mirror therapy in addition to the conventional stroke rehabilitation programme. Patients were assessed in terms of motor recovery (Brunnstrom stages), spasticity (modified Ashworth Scale), and the self-care items of the Barthel index. These indices were measured at 0 month (pretreatment), 1 month (post-treatment), and 6 months (follow-up). There was a statistically significant difference in spasticity improvement between the study and control groups; however no significant difference was seen in motor recovery and self care items between the groups. The patients had significant improvements within the groups after the therapy for one month. Mirror therapy can be a useful intervention supplement in rehabilitation of patients; it provides a simple and cost effective therapy for recovery of hand function.

scholarly journals Effectiveness of mirror therapy in the motor recovery of upper extremity in the post stroke hemiplegic patients: a randomized controlled trial in a tertiary care hospital in Manipur, Northeast India

2019 ◽  
Vol 6 (5) ◽  
pp. 1657
Author(s):  
Ningthemba Yumnam ◽  
Joy Singh Akoijam ◽  
Longjam Nilachandra Singh ◽  
Joymati Oinam
Keyword(s):  
Upper Extremity ◽  
Stroke Rehabilitation ◽  
Controlled Trial ◽  
Self Care ◽  
Rehabilitation Program ◽  
Motor Recovery ◽  
Mirror Therapy ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Significant Difference

Background: Stroke is a leading cause of disability and majority of the stroke survivors experience upper extremity functional limitations. Therefore, the objective of this study was to evaluate the effectiveness of mirror therapy in addition with a conventional upper limb rehabilitation program in a post stroke hemiplegic patient.Methods: A randomized controlled trial was conducted among 72 post stroke patients aged 35-65 years having hemipa¬resis attending the PMR department, RIMS, Manipur from 2013 to 2016. Assessment was done at baseline, 1 and 6 months for FIM self care, Brunnstrom stages of motor recovery and MAS for spasticity. Both the group participated in a stroke rehabilitation program and study group was given mirror therapy in addition. Descriptive statistics such as mean±SD and inferential statistics like Chi-square test, Student’s t test, and ANOVA were used. A p-value < 0.05 was taken as statistically significant.Results: There was an improvement in Brunnstrom stage and FIM self-care score in both groups, but the post-treatment score was significantly higher in the mirror therapy group. Statistically significant difference in FIM self care and motor recovery between the study and control groups was noted [1.1±0.38 (study) versus 0.88±0.32 (control) for motor recovery and 34.1±2.59 (study) versus 29.5±4.58 (control) for FIM self care]. However, no significant difference was seen in spasticity between the groups.Conclusions: Mirror therapy used in addition to conventional stroke rehabilitation program was found to be effective in the recovery of upper extremity motor functions and daily self care activities in post stroke hemiplegic patients.

scholarly journals Effect of proprioceptive sensation and feedback required for motor learning on function, activity, and daily life behavior of patients after nerve injury

2021 ◽  
Vol 11 (3) ◽  
pp. 474-481
Author(s):  
Jung-Ho Lee
Keyword(s):  
Upper Extremity ◽  
Daily Activities ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Proprioceptive Sensation ◽  
Significant Difference ◽  
Upper Extremity Function ◽  
Function Activity ◽  
Experimental Group

Purpose: This study investigated the effects of modified mirror therapy and taping therapy for providing feedback on upper extremity function, activity, and daily activities of stroke patients. Methods: This study was conducted with 20 stroke patients and randomly assigned 10 subjects to the experimental group and 10 to the control group. In the experimental group, after proprioceptive neuromuscular stimulation treatment, the mirror therapy program was implemented. In the control group, upper extremity taping was performed before proprioceptive neuromuscular facilitation treatment. In this study, a prior evaluation using JTT, FIM, and MAL was performed before intervention to evaluate the patient's function and daily life behavior. Post-tests were performed after the last treatment. Results: In the paired-sample T-test used for within-group comparison of JTTs, FIM, and MAL, there was a significant difference between pre- and post-test for all groups. But there was no statistically significant difference between experimental group 1 and experimental group 2 in an independent t-test conducted to compare the effect sizes of treatments. Conclusion: In other words, by applying mirror therapy and taping therapy that can increase proprioceptive sensation and feedback information in stroke patients, upper extremity function and daily activities can be increased.

scholarly journals The effect of ladder approach on development of preterm low birth weight infants with HIE-2

2020 ◽  
Vol 7 (3) ◽  
pp. 520
Author(s):  
Tushar R. Jadhav ◽  
Shailaja S. Jaywant
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Post Intervention ◽  
Low Birth Weight Infants ◽  
Significant Difference

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.

scholarly journals A Structured Maternity Case Record to Improve Quality of Documentation in a Tertiary Care Hospital, Delhi

2021 ◽  
Author(s):  
AG Radhika ◽  
Chetna Dengri ◽  
Abhishek Kumar ◽  
Shalini Singh
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Control Group ◽  
Care Hospital ◽  
Case Record ◽  
Hospital Case ◽  
Sequence Of Events ◽  
Significant Difference ◽  
Time Of Admission

Introduction: India contributes to about 18% of global maternal deaths and 22.6% of still births. Efforts to improve the quality of care are challenged by the lack of reliable documentation of data. Hence, a concise, structured maternity case sheet (PrasavRecord) was designed with the aim to bring about an improvement in documentation of treatment and events related to woman in labour from the time of admission till her discharge from the hospital. Aim: To study the improvement in quality of documentation from the time of admission till discharge of a woman in labour with the help of structured format i.e., PrasavRecord. Materials and Methods: The study was conducted in February 2017. A quasi experimental study design was used, and the completeness of data recorded by the resident doctors in the existing hospital case sheet (control group) with those recorded in PrasavRecord (intervention group) were assessed in a total of 65 deliveries in each arm. Details of the patient from admission to the labour room followed by the entire sequence of events during labour as well as hospital stay in postpartum period were recorded over 130 parameters under different sections in PrasavRecord. Statistical analysis was done by using SPSS version 21.0. Results: Completeness of the documentation in terms of history, investigations and findings at examination including those at labour, nearly, 92% of the doctors rated PrasavRecord as “good and very good” for appearance, recommended its routine use, and 75% agreed that the format will be useful for conversion to electronic medical record. There was highly significant difference between the average percentage of completeness in PrasavRecord 75.8 {95% CI (74.2-77.4)} and hospital case sheets 42.2 {95% CI (40.9-43.6)} i.e., z=5.38 p-value <0.001. Conclusion: PrasavRecord is a simple, acceptable and user-friendly data entry format which improves the quality of documentation of the processes and practices during childbirth. Larger trials are required to finetune it to facilitate its widespread use thereby, ensuring a uniform documentation process of labour and postpartum.

scholarly journals Therapeutic study of onychomycosis in a tertiary care center

2019 ◽  
Vol 5 (3) ◽  
pp. 517
Author(s):  
Geetha K. ◽  
Muthubharathi S.
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Nail Plate ◽  
Care Hospital ◽  
Open Label ◽  
Treatment Protocols ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Group A ◽  
Oral Terbinafine

<p class="abstract"><strong>Background:</strong> Onychomycosis is the fungal infection of nail unit and require long-term treatment to achieve complete cure. This study aims to know the effectiveness of various treatment protocols for onychomycosis.</p><p class="abstract"><strong>Methods:</strong> This randomized uncontrolled open label study was undertaken in a tertiary care hospital. Patients with onychomycosis were included. Patients who received systemic or topical antifungal therapy in last six months were excluded. After obtaining ethical approval they were subjected to KOH mount and culture from nail clippings. Patients were selected randomly with both KOH and culture positive. Patients were divided into 3 groups. Group-A received oral terbinafine, Group-B received oral terbinafine and topical amorolfine, Group-C received oral itraconazole and topical amorolfine for 6 months. The patients were evaluated and assessed for the growth of the nail plate and were inquired for any adverse effects due to the drugs, at 6, 12 and 24 weeks. The results were recorded and detailed statistical analysis was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the course of study 9 patients were lost in follow up and were excluded from the analysis of results. Mycological cure with negative KOH microscopy and culture were obtained in 56.6%, 73.3% and 70% in groups A, B and C. Clinical cure was observed in 60%, 76.6%, and 73.3% patients in group A, B and C respectively.</p><p class="abstract"><strong>Conclusions:</strong> There was no statistically significant difference in cure rate among the different treatment groups. Combination therapy achieved better results compared to monotherapy.</p>

scholarly journals COMPARATIVE STUDY OF AST: ALT RATIO IN LIVER DISEASES IN A TERTIARY CARE HOSPITAL IN BAREILLY

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Ajaya Kumar Anand ◽  
Dr. Govind Singh
Keyword(s):  
Chronic Hepatitis ◽  
Obstructive Jaundice ◽  
Viral Hepatitis ◽  
Liver Diseases ◽  
Alcoholic Hepatitis ◽  
Tertiary Care ◽  
Serum Levels ◽  
Control Group ◽  
Care Hospital ◽  
Significant Difference

Background: Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT), the enzymes predominantly found in the hepatocytes, exhibit specific elevations in serum levels in different liver diseases. The ratios of their serum levels (AST: ALT ratio or De Ritis ratio) also exhibit specific patterns providing important diagnostic clues. The objective of the study is to establish the diagnostic utility of the AST: ALT ratio in liver diseases. Material and methods: The present study was conducted to measure the serum levels of these enzymes from the blood samples collected from a total of 60 patients with diagnosis of Alcoholic Hepatitis (AH, n= 18), Viral Hepatitis (VH, n= 18), Obstructive Jaundice (OJ, n= 06) and Chronic Hepatitis (CH, n= 18) to calculate their ratio as Mean ± SD, separately in each disease group. 24 normal healthy individuals were studied as control group. The data was analyzed using SPSS (Version 17.0) software and ‘p’ values were elicited using student-‘t’ test. Results: An AST: ALT ratio of 2.005±0.833, 0.648±0.228, 0.865±0.147 and 1.314±0.305 was observed in AH, VH, OJ and CH respectively. Control group showed a mean AST: ALT ratio of 1.001±0.158. A significant difference (p<0.05) was observed when each case group was compared with control except OJ vs Control where the ‘p’ value was observed >0.05.  A significant difference (p<0.05) was observed when comparison was done between any two of the disease groups. Conclusion: AST: ALT ratio can be useful in differentiating the liver diseases. Key words: AST:ALT ratio, De Ritis ratio, Alcoholic Hepatitis, Viral Hepatitis, Obstructive Jaundice and  Chronic Hepatitis.

The Effectiveness of Mirror Therapy to Upper Extremity Rehabilitation in Acute Stroke Patients

2021 ◽  
Author(s):  
Phassakorn Klinkwan ◽  
Chalunda Kongmaroeng ◽  
Sombat Muengtaweepongsa ◽  
Wiroj Limtrakarn
Keyword(s):  
Acute Stroke ◽  
Upper Extremity ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Home Exercise ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients

Rehabilitation is a crucial part of stroke recovery to help them regain use of their limb. The aim of this article was to compare the effectiveness of long-term training of mirror therapy with conventional rehabilitation therapy on neurological and recovery of upper limb in acute stroke patients. In this randomized and assessor-blinded control study, 20 acute stroke patients were analyzed in this study and allocated to a case (n = 10, 50.6 ± 17.90 years) and control group (n = 10, 55.9 ± 11.25 years). All the participants performed daily home exercise during 12 weeks. The patients in the control group were treated with conventional therapy (CT) and a group of cases were treated with mirror therapy (MT) alone program. The outcome measurements were assessed by a therapist blinded assessor using Fugl-Meyer Assessment (FMA) upper extremity score, Brunnstrom recovery stages (BRS), Modified Ashworth Scale (MAS) and Muscle Strength to evaluate upper limb motor function and motor recovery. Data were analyzed using Wilcoxon and Mann-Whitney U tests to compare within-groups and between-group differences. The results revealed that, after 12 weeks of treatment, patients of both groups presented statistically significant improvements in all the variables measured (p < 0.05). Compared with the control group, the patients of the MT group had greater improvement in the proximal movement portion of the FMA upper extremity mean score change (15.8 ± 3.2 versus 10.0 ± 2.7, p = 0.002) while there were no differences in other variables (p > 0.05). There were also no adverse events. It suggests that 12 weeks training of mirror therapy alone was likely to improve the motor recovery of the upper limb and activity of daily living in acute stroke patients than conventional therapy, if treated early.

scholarly journals Staphylococcus spp Resistance to Chlorhexidine: Is There Any Impact Related to the Routine Use for Hand Hygiene?

2020 ◽  
Vol 41 (S1) ◽  
pp. s390-s391
Author(s):  
Icaro Boszczowski ◽  
William Kazumassa Minami ◽  
Marcia Baraldi ◽  
Ana Paula Marchi ◽  
nia Alves dos Santos ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Efflux Pump ◽  
Tertiary Care ◽  
Intervention Group ◽  
Sodium Thiosulfate ◽  
Brain Heart Infusion ◽  
Control Group ◽  
Care Hospital ◽  
Significant Difference ◽  
The Impact

Background: Although guidelines recommend the use of chlorhexidine gluconate (CHG) for hand hygiene (HH), the impact of its routine use on antimicrobial resistance is not clear. Objective: To analyze the impact on the CHG susceptibility among isolates obtained from hands of HCW during its routine use for HH. Methods: We conducted a crossover study at 4 medical-surgical wards of a tertiary-care hospital in São Paulo, Brazil. In 2 units (intervention group), we established routine use of CHG for HH. For the other 2 units (control group), regular soap was provided. The availability of alcohol formulation for HH was not changed during the study. Every 4 months we swapped the units, ie, those using CHG changed for regular soap and vice versa. At baseline, we cultured the hands of HCWs. Only nursing staff hands were investigated. For hand culturing, HCWs placed their hands inside a sterile bag containing a solution of phosphate-buffered saline, Tween 80, and sodium thiosulfate. After the solution incubated overnight, it was inoculated onto brain-heart infusion. Next, it was plated on McConkey and Mannitol agar. MALDI-TOF was used for identification. Agar dilution was performed for Staphylococcus spp. We selected all Staphylococcus spp with MIC ≥ 8 and performed inhibition of efflux pump test. For isolates that showed a decrease of 2 dilutions, we searched the gene qacA/B by polymerase chain reaction. Results: We obtained 262 samples from HCW hands yielding 428 isolates. The most frequent genera were Staphylococcus spp (58%), Acinetobacter spp (8%), Enterobacter spp (8%), Stenotrophomonas spp (5%), Klebsiella spp (4%), Pseudomonas spp (3%), and others (14%). Staphylococcus spp were less frequent in the intervention compared to control group (43% vs 61%; OR, 0.48; 95% CI, 0.29–0.69; P = .005). Among all Staphylococcus spp, the proportion of chlorhexidine resistance (RCHG; MIC ≥ 8) was 12%. All resistant isolates recovered susceptibility after inoculation with pump-efflux inhibitor. For pump-inhibited isolates, 53% had the gene qacA/B amplified by PCR. We did not investigate RCHG among gram-negative isolates. There was a nonsignificant increase in Staphylococcus spp RCHG in the intervention group (4% to 6%; P = .90). Healthcare-acquired infection rates did not change significantly during the intervention. The consumption of CHG increased from 7.3 to 13.9 mL per patient day. Conclusions: We did not detect a significant difference in RCHG during the routine use of CHG for HH, although we observed increasing resistance. Further investigation is needed to clarify other reasons for increasing MIC to CHG.Funding: NoneDisclosures: None

scholarly journals Application Of Mirror Therapy On Upper Extremity Motor Recovery In Post-Stroke Patients

2021 ◽  
pp. 136-144
Author(s):  
Roh Hastuti Prasetyaningsih ◽  
Hendri Kurniawan
Keyword(s):  
Upper Extremity ◽  
Motor Recovery ◽  
The Body ◽  
P Value ◽  
Mirror Therapy ◽  
Research Subjects ◽  
Hand Rehabilitation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Significant Difference

Background: Stroke is a health problem for both developed and developing countries, including Indonesia. Paralysis in stroke is mainly due to damage to the internal capsule. This damage requires neuroplasticity involving a number of parts of the brain to restore. One therapy that is beneficial for neuroplasticity is Mirror Therapy (MT). MT is a rehabilitation tool that aims to restore some of the pathological conditions in which the body representation is affected, including post-stroke motor impairment. Methods: This research is a quantitative pre-experimental design with the type one group pretest-postest. The research subjects were 15 post-stroke patients in residency of Semarang. Research data were collected in August-September 2020. Sample selection with  purposive sampling technique who conform inclusion criteria. The Fulg-Meyer Upper Extremity Assessment (FMA-UE) as an aoutcame measure that be avowed valid and reliabel. Data analysis using Paired Sample T-Test because of normally distributed. Results: Statistically the results represent a significant difference in the UE  motor ability of post-stroke patients between baseline and after mirror therapy intervention, with a mean difference (5,14) and p value =  0.000  (ρ < 0,05). Application  of MT effect on upper extremity motor recovery in post-stroke patients. Conclusions: MT program is an effective intervention for UE motor recovery and motor function improvement in post- stroke patients. MT program can be used as a standardized of hand rehabilitation intervention in hospital, clinics and homes.

scholarly journals Impact of microvascular complications on quality of life in diabetic patients

2020 ◽  
Vol 2 (2) ◽  
pp. 43-47
Author(s):  
Priyanka Kulla ◽  
Shruthi Pusala ◽  
Sandeep Kumar Beemreddy
Keyword(s):  
Quality Of Life ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Self Care ◽  
Health Concern ◽  
Diabetic Patients ◽  
Related Factor ◽  
Care Hospital ◽  
Significant Difference

ABSTRACTIntroduction: Diabetes is a serious health concern all over the world. Among people with diabetes, a key factor influencing quality of life (QOL) is degree and nature of diabetes related complications experienced by the patients over a lifetime. QOL is important health related factor and one of the most widely used measure to self-assess the effect of the management of chronic disease on health and monitors the physical, psychological, and social aspects of personal health.Methodology: This study is a prospective questionnaire based observational study which was conducted over a period of 6 months in a tertiary care hospital among diabetic patients. The subjects are interviewed with WHOQOL-BREF questionnaire and relevant information was collected. The domain wise scores are calculated.Results: A total of 140 diabetic patients were included in the study of which 100 were with complications and 40 were without complications. On conducting single sample unpaired test analysis, we found significant difference in the patients. The inference obtained this study was that nephropathy is the most common microvascular complication and affects the psychological and environmental status of subjects.Conclusion: The study was done to know the influence of complications on QOL and to reduce the burden of disease by improving QOL by effective counselling points and self-care management. We conclude that taking proper diabetic diet and self-care can prevent the worsening of QOL in patients with microvascular complications.  

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