Neurophysiological mechanisms and functional impact of mirror movements in children with unilateral spastic cerebral palsy.
Hsing-Ching Kuo, Kathleen M Friel, Andrew M Gordon
PMID 28884806WHAT IT FOUND
Mirror movements in children with unilateral spastic cerebral palsy may reflect abnormal wiring from the uninjured side of the brain to both hands.
They are linked to poorer hand use, but these links do not prove cause or predict therapy response.
Key findings
01About 40% to 50% of children with unilateral spastic cerebral palsy have the more affected upper limb controlled only by the non-lesioned side of the brain, and this pathway is linked to mirror movements.
02Mirror movements are associated with poorer hand function, but the review says the association is low to moderate and does not prove cause.
03The review suggests mirror movements could be used as a clinical surrogate for corticospinal tract organization, but therapy response studies are inconsistent.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This is a narrative review, not a systematic review, so it does not report a full search, quality appraisal, or pooled analysis. The article summarizes studies of different designs and sizes, so the strength of evidence is not equal across claims. Mirror movements were measured in different ways across studies, including clinical scoring, force transducers, and behavioral tasks. The review reports associations between mirror movements and hand function, not proof that mirror movements cause poor function. The studies of therapy response give inconsistent results, so mirror movements cannot be treated as a proven predictor of who benefits from intensive hand therapy. Many clinicians cannot access brain stimulation or imaging tests used in the cited mechanism studies. The role of mirror movements in more severely impaired children is unclear because some may use them as an assistive strategy.
Declared interests
The publication record lists non-U.S. government research support, but no author conflict-of-interest statement is provided.
The easy way to misread this
Do not conclude that mirror movements cause poor hand function or that they reliably guide therapy choices. The review reports associations, not proof of cause, and the therapy prediction studies were inconsistent.