Clinical study of combined mirror and extracorporeal shock wave therapy on upper limb spasticity in poststroke patients.
Junyi Guo, Shuyan Qian, Yisu Wang and 1 others
PMID 30211721WHAT IT FOUND
For poststroke upper limb spasticity, adding mirror therapy and shock wave therapy to usual rehabilitation showed better arm movement and lower tone scores than adding either one alone or usual rehabilitation alone.
Key findings
01The group receiving usual rehabilitation plus mirror therapy and shock wave therapy had higher upper limb motor scores than the group receiving usual rehabilitation only.
02The group receiving usual rehabilitation plus mirror therapy and shock wave therapy had lower tone scores than the group receiving usual rehabilitation only.
03The group receiving usual rehabilitation plus mirror therapy and shock wave therapy had higher upper limb motor scores than the groups receiving usual rehabilitation plus mirror therapy only or usual rehabilitation plus shock wave therapy only, especially at 6 and 12 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study only included people who could understand simple instructions and had no cognitive problems, so it may not apply to more severe or confused stroke survivors. Only the outcome assessors were kept unaware of treatment; the text does not state that patients or therapists were blinded. The paper does not state which outcome was primary, so the reported motor and tone results cannot be ranked as the main test of the hypothesis. The combined group received usual rehabilitation plus mirror therapy and shock wave therapy, so the contribution of each added component cannot be separated. It was a single-site study in China, so results may not apply to other settings.
The easy way to misread this
Do not conclude that mirror therapy and shock wave therapy by themselves caused the benefit. The combined group also received conventional rehabilitation, and the study did not isolate the contribution of each added component.