1. 1. Archimedes and the Battle of Syracuse Using mirrors to burn the Romans ships
2. 2. The Reflecting Pool
3. 3. MIRROR THERAPY Aswathi.p 1st yr Msc Nursing Al Shifa college of nursing
4. 4. MIRROR THERAPY Unveiled by Vilayanur S. Ramachandran & Rogers 1996 Recognize & integrate mismatch propioception &visual feed
5. 5. MIRROR THERAPY
6. 6. EQUIPEMENTS Mirror box
7. 7. MIRROR THERAPY
8. 8. TECHNIQUE places good limb into one side, & stump in to other, looks into mirror on the side with good limb &makes"mirror symmetric movement, as a symphony conductor might, or as we do when we clap our hands.
9. 9. PRINCIPLE
10. 10. MIRROR NEURON Frontal & parietal lobes Rich in motor command neurons Fires to orchestrate sequence of muscle twitches
11. 11. MIRROR THERAPY & STROKE
12. 12. Residue of mirror neurons Incomplete lesion STROKE Cont.
13. 13. Cont Visual feed back - Revive motor neurons Areas are temporarily inactive Does not reach threshold
14. 14. MIRROR THERAPY &PHANTOM LIMB PAIN
15. 15. Cont Learned pain Vivid presence of limb Amputation
16. 16. Cont Activation of mirror neurons Mirror visual feed back Learned immobilization
17. 17. Cont Free from phantom limb pain Start to imitate action performance
18. 18. MIRROR THERAPY & CRPS
19. 19. con Accidental signals to limb evokes memories of pain Attempt to move causes pain Inflammation
20. 20. Unlearning of learned pain & learned immobilization Conveys visual illusion MIRROR VISUAL FEED BACK
21. 21. OTHER USES Focal dystonias Dejerrine Roussy syndrome Trigeminal neuralgia Parkinson disease
22. 22. REVIEW OF LITERATURE Mirror therapy for improving motor function after stroke
23. 23. Mirror therapy for improving motor function after stroke
24. 24. ABSTRACT Citation: Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. Mirror therapy for improving motor function after stroke.
25. 25. Cont.. Background Mirror therapy is used to improve motor function after stroke. During mirror therapy, a mirror is placed in the patients midsagittal plane, thus reflecting movements of the non-paretic side as if it were the affected side
26. 26. Cont.. Objectives To summarise effectiveness of mirror therapy compared with no treatment, placebo or sham therapy
27. 27. Cont.. To summarise effectiveness of mirror therapy for improving motor function, activities of daily living, pain & visuospatial neglect in patients after stroke.
28. 28. Cont.. Methods Randomised controlled trials & randomised cross-over trials comparing mirror therapy with any control intervention for patients after stroke.
29. 29. Cont Type of participants Paresis of upper or lower limb, or both, caused by stroke (all types, severity & stages of stroke) aged over 18 yrs.
30. 30. Cont.. Types of outcome measures Post-intervention (or change scores between pre- and post intervention measures) and at follow-up after six months or longer.
31. 31. Cont.. Primary outcomes Motor function Secondary outcomes Measures of activities of daily living
32. 32. Cont.. Data collection and analysis Two review authors independently selected trials based on the inclusion criteria, documented methodological quality of studies and extracted data. We analysed the results as standardised mean differences (SMDs) for continuous variables.
33. 33. Cont.. Resuls Included 14 studies with a total of 567 participants that compared mirror therapy with other interventions.
34. 34. Cont.. post-intervention data: SMD 0.61; 95% confidence interval (CI) 0.22 to 1.0; P = 0.002; change scores: SMD 1.04; 95% CI 0.57 to 1.51; P < 0.0001
35. 35. Cont.. However, effects on motor function are influenced by the type of control intervention. Additionally, mirror therapy may improve activities of daily living.
36. 36. Cont.. (SMD 0.33; 95% CI 0.05 to 0.60; P = 0.02). We found a significant positive effect on pain (SMD -1.10; 95% CI 2.10 to -0.09; P =0.03) which is influenced by patient population.
37. 37. Cont.. We found limited evidence for improving visuospatial neglect (SMD 1.22; 95% CI 0.24 to 2.19; P = 0.01). The effects on motor function were stable at follow-up assessment after six months.
38. 38. A small spark can ignite thousands of light
39. 39. Small spark to ignite thousands of hope among stroke survivors & amputees