Brunnstrom Movement Therapy Versus Mirror Therapy on Hand Function in Stroke

April 18, 2023 updated by: Riphah International University

Brunnstrom Movement Therapy Versus Mirror Therapy on Hand Function in Stroke Hemiplegic Population

This study will be randomized clinical trial. Non Probability consecutive sampling technique will be used. Data will be collected from patients having stroke by using tools i.e Fugl-Meyer assessment: wrist and hand (FMA- WH) and Brunnstrom Hand Manipulation (BRS-H). Those who will meet inclusion criteria will be recruited. An informed consent will be taken from all patients. The recruited subjects will be assessed according to outcome measures. Patients will be divided into 2 groups. Group A will be treated with Brunnstrom Movement Therapy plus Conventional therapy for 1 hour, 3 sessions per week (4 weeks) and Group B will be treated with Mirror Therapy plus Conventional therapy for 45 min, 3 sessions per week ( 4 weeks) 5 movements, 10 repetitions. Outcome measures will be measured at baseline, 2 weeks and after 4 weeks. Data analysis will be done by Statistical Package for the Social Sciences version 25.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Stroke commonly known as Cerebro-Vascular Accident (CVA), is stated as a sudden commencement of neurological discrepancy which is attributable to a pivotal vascular basis. In modest words, it is a "brain attack", which occurs when the brain fails to get adequate blood circulation, as a result, brain cells do not get a sufficient amount of oxygen, and cells start dying ultimately. Brunnstrom movement therapy uses reflexes to develop movement behavior through sensory stimulation, in order to inhibit spasticity and movement retraining to enhance recovery. Mirror therapy (MT) in stroke patients involves performing unimpaired limb movements while observing there reflection of the mirror overlapping the impaired limb, creating a visual illusion of increased movement capacity in the impaired limb.

In previous researches, various conventional and contemporary approaches such as Brunnstrom, and Mirror therapy have been used to rehabilitate the hand after stroke in clinical settings. Previous literature was focus on digital and other conventional methods. However, despite a revolution in the number of therapeutic protocols, evidence of efficacy remains limited. Both BHM and MT have been studied separately to evaluate their respective effectiveness. However, no study has been found comparing the two protocols exclusively for hand motor recovery.

Study Type

Interventional

Enrollment (Actual)

26

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54000
        • Sargodha Rafiqa Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

40 years to 60 years (Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

- Both genders

  • Patient population of adults 40-70 years old
  • Any type of stroke (ischemic or hemorrhage)
  • upper extremity, hand impairment
  • (include stage here) on brunnstorm scale

Exclusion Criteria:

  • inability to follow commands

    • inability to sit more than 2 h (self-report)
    • Botox injection/chemo-denervation within the last 6 months
    • presence of cardiac pacemaker
    • current participation in other interventions/studies

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A
Brunnstrom movement therapy
Other: Brunnstrom movement therapy.

Group A: Will be treated with Brunnstrom movement therapy for three days in a week for four weeks (1 h) approximately 12 sessions to every subject.

Subjects received Brunnstrom hand manipulation (BHM) and conventional occupational therapy for the upper extremity and lower extremities. The detailed BHM is applied on hand. The major goal of the BHM was the acquisition of mass grasp and mass release of objects. Once the goal was achieved, more prehensile activities were focused. Reflexive, passive, synergistic and active movements were used sequentially to enhance the hand recovery.
Experimental: Group B
Mirror therapy
Other: Mirror Therapy

Group B: Will be treated with Mirror therapy 45 minutes, for three days in a week for four weeks approximately 12 sessions to every subjects.

First 30 minutes therapy consists of conventional therapy as given conventional tasks only with the affected upper extremity. 15 minutes were continued with mirror. Mirror is placed in front of the midline of the patient so that the affected limb is fully covered by the mirror and the reflection of the unaffected limb is fully visible. The affected limb positioned in a safe and comfortable position behind the mirror. The non-affected limb should be positioned in a similar position as the affected limb, as this facilitates the intensity of the mirror illusion. Patients in the experimental group received 45 minutes of consecutive session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Fugl-Meyer assessment
Time Frame: 4th week
wrist and hand (FMA-WH) subtest (item VII, VIII and IX), used as, item VII measures the wrist control; VIII measures the hand motor recovery (mass finger flexion, extension and grasp) and IX measures coordination of the movements.
4th week
Brunnstrom Hand Manipulation (BRS-H)
Time Frame: 4th Week
Brunnstrom Hand Manipulation (BRS-H) was used to determine motor recovery level of post-stroke patients. It consists of 6 hand stages.
4th Week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Mehwish Ikram, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 30, 2022

Primary Completion (Actual)

December 30, 2022

Study Completion (Actual)

January 30, 2023

Study Registration Dates

First Submitted

May 23, 2022

First Submitted That Met QC Criteria

May 23, 2022

First Posted (Actual)

May 26, 2022

Study Record Updates

Last Update Posted (Actual)

April 19, 2023

Last Update Submitted That Met QC Criteria

April 18, 2023

Last Verified

April 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR &AHS/22/0205

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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