Dawn M. Nilsen, Theresa DiRusso; Using Mirror Therapy in the Home Environment: A Case Report. Am J Occup Ther 2014;68(3):e84-e89. doi: 10.5014/ajot.2014.010389.
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© 2019 American Occupational Therapy Association
OBJECTIVE. Mirror therapy (MT) is a potential intervention to improve function after stroke. How to apply this intervention in practice is not clear. This case report illustrates the feasibility and effectiveness of a self-administered home-based MT program.
METHOD. A home-based MT program was practiced over 5 wk. The participant was encouraged to use MT for 30 min 5×/wk. Therapist contact occurred 1×/wk to monitor performance. An independent evaluator administered three outcome measures pre- and postintervention: Upper Extremity Sensory and Pain sections of the Fugl-Meyer Assessment; Jebsen–Taylor Test of Hand Function, and the Manual Ability Measure–20.
RESULTS. The participant engaged in a mean of 39.23 (±7.44) min of MT per day and used a variety of the recommended activities. Change scores indicated improvement on all of the included outcome measures.
CONCLUSION. This case report suggests that a predominantly self-administered home-based MT program is feasible and effective at improving function after stroke.
The UE section of the Fugl-Meyer Assessment (FM), Sensory section (scores range from 0 to 12, and higher scores indicate better sensation) and Pain section (scores range from 0 to 24, and higher scores indicate less pain; Fugl-Meyer, Jääskö, Leyman, Olsson, & Steglind, 1975). The FM has high test–retest reliability (r = .99) and interrater reliability (rs = .96–.97; Duncan, Propst, & Nelson, 1983).
The Jebsen–Taylor Test of Hand Function (JTTHF; Jebsen, Taylor, Trieschmann, Trotter, & Howard, 1969). The JTTHF evaluates hand function, and it has strong test–retest reliability (rs = .67–.99; Jebsen et al., 1969; Stern, 1992) and validity in predicting hand use in ADLs (Lynch & Bridle, 1989). We summed the times for six of the seven subtests (the writing subtest was removed) of the JTTHF to provide a total time score; faster times indicate greater hand function.
The Manual Ability Measure–20 (MAM–20), a self-report measure of hand function. Scores range from 0 to 100, and higher scores indicate greater hand function (Chen, 2011). The MAM–20 is a shortened version of the MAM–36, which is an instrument that has established validity (Chen & Bode, 2010).
MT may improve occupational performance in chronic stroke survivors.
MT can be successfully self-administered by motivated clients as a home-based intervention.
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