Mirror therapy for the treatment of upper limb impairment after stroke

: investigation of the feasibility aims of a pilot randomised controlled trial

Abstract

The aim of this thesis was to assess the feasibility of the outcome measures included in a pilot randomised controlled trial of mirror therapy in upper limb rehabilitation and to explore the acceptability of mirror therapy within three months of stroke onset.
A systematic literature review investigated the contextual application and psychometric properties of the graded Wolf Motor Function Test, an upper limb assessment tool and indicated psychometric evaluation was essential. Assessment of the reliability (n=30) and responsiveness (n=40) of the graded Wolf Motor Function Test was completed, followed by assessment of the responsiveness of the Functional Independence Measure (n=40) and patient-reported outcome measures (n=39) included in the pilot trial. Finally, a focus group study was conducted to explore perceptions of mirror therapy by stroke survivors (n=3).
The graded Wolf Motor Function Test was reliable and responsive, and findings indicated the use of video for scoring may not be required. The Functional Independence Measure and patient-reported outcome measures demonstrated adequate responsiveness. However, in light of the level of attrition found by six-month follow-up, continuing assessments at this time point was not recommended. Themes identified from the focus group indicated the importance of therapist actions to facilitate stroke survivors to self-manage their recovery within and beyond the hospital setting.
This PhD thesis has contributed to the development of a main trial examining the effectiveness of mirror therapy, which is currently underway. Although considered important to stroke survivors, patient-reported outcome measures are not often reported in clinical trials and this is the first study to assess the responsiveness of those included, in the early stages of stroke. The focus group study provided a novel exploration of stroke survivors perceptions of mirror therapy treatment. This thesis contributes to the choice of outcome measure and treatment by occupational therapists in upper limb stroke rehabilitation.

Date of Award	Oct 2020
Original language	English
Sponsors	Department for the Economy & United Kingdom Occupational Therapy Research Foundation
Supervisor	May Stinson (Supervisor) & Alison Porter-Armstrong (Supervisor)