Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Video Based Behavioral Analysis to Observe Attention during Mirror Therapy in Hemiplegic Patients : Preliminary Study

  • Kim, Jinmin (Department of Physical Therapy, College of Health and Welfare, Sahmyook University) ;
  • Song, Changho (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • Received : 2021.06.13
  • Accepted : 2021.06.16
  • Published : 2021.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: Mirror therapy is one of the promising methods suggested for the upper limb rehabilitation of stroke patients. While mirror therapy was presented to be effective in improving motor function of stroke patients, problems were raised as preceding studies had various methods in applying mirror therapy. Some studies even reported no effect in mirror therapy. Our supposition for the reason of such problems was a decrease of attention on the illusive image during mirror therapy of stroke patients, and we aimed to observe this. Design: A cross-sectional preliminary study. Methods: Three hemiplegic acute patients were recruited for the traditional mirror therapy. It lasted for 30 minutes, and 12 different tasks were asked to perform. All procedures were video-recorded, and Observer XT was used to analyse mirror-gazing time, gaze-distracted time, preparation time, frequency of mirror gazing, frequency of distraction, frequency of preparation for treatment. Results: Subjects spent an average of 4-5 minutes having instructions about the mirror therapy intervention (preparation duration), an average of 11 minutes watching the mirror during therapy (mirror-gazing duration), and the rest of 14-15 minutes looking around the environment (gaze-distracted duration). During the mirror therapy, the number of distracted moments (frequency of distraction) was eight times more than focusing on the mirror (frequency of mirror gazing). Conclusions: Once the patient looks at the mirror, it only lasts about 5 seconds on average. Thus, we confirmed that patients could not concentrate on the illusion during the session and therefore it may have affected the effectiveness of the therapy.

Keywords

Acknowledgement

이 논문은 2018년도 정부(교육부)의 재원으로 한국연구재단의 지원을 받아 수행된 기초연구사업임 (No. NRF-2018R1D1A1B07043319)

References

  1. Ramachandran VS, Rogers-Ramachandran D, Cobb S. Touching the phantom limb. Nature. 1995;377:489-90. https://doi.org/10.1038/377489a0
  2. Ramachandran VS, Rogers-Ramachandran D. Mirror feedback assisted recovery from hemiparesis following stroke. In Reply to Morkisch et al.: How to perform mirror therapy after stroke? Evidence from a meta-analysis. Restor Neurol Neurosci. 2019;37:437-43.
  3. Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, et al. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2018;7:CD008449.
  4. Morkisch N, Thieme H, Dohle C. How to perform mirror therapy after stroke? Evidence from a meta-analysis. Restor Neurol Neurosci. 2019;37:421-35.
  5. Antoniotti P, Veronelli L, Caronni A, Monti A, Aristidou E, Montesano M, et al. No evidence of effectiveness of mirror therapy early after stroke: an assessor-blinded randomized controlled trial. Clin Rehabil. 2019;33:885-93. https://doi.org/10.1177/0269215518824737
  6. Barker-Collo SL, Feigin VL, Lawes CM, Parag V, Senior H, Rodgers A. Reducing attention deficits after stroke using attention process training: a randomized controlled trial. Stroke. 2009;40:3293-8. https://doi.org/10.1161/STROKEAHA.109.558239
  7. Kal E, van den Brink H, Houdijk H, van der Kamp J, Goossens PH, van Bennekom C, et al. How physical therapists instruct patients with stroke: an observational study on attentional focus during gait rehabilitation after stroke. DisabilRehabil. 2018;40:1154-65.
  8. Ducharme DA, Arcand I. Using Noldus Observer XT for research on deaf signers learning to read: an innovative methodology. Behav Res Methods. 2009;41:833-40. https://doi.org/10.3758/BRM.41.3.833
  9. Deconinck FJ, Smorenburg AR, Benham A, Ledebt A, Feltham MG, Savelsbergh GJ. Reflections on mirror therapy: a systematic review of the effect of mirror visual feedback on the brain. Neurorehabil Neural Repair. 2015;29:349-61. https://doi.org/10.1177/1545968314546134
  10. Hyndman D, Pickering RM, Ashburn A. The influence of attention deficits on functional recovery post stroke during the first 12 months after discharge from hospital. J Neurol Neurosurg Psychiatry. 2008;79:656-63. https://doi.org/10.1136/jnnp.2007.125609
  11. Schmidt RA, Lee TD. Motor control and learning: A behavioral emphasis. 5th ed. Champaign: Human Kinetics; 2011.
  12. McDowd JM, Craik FIM. Effects of aging and task difficulty on divided attention performance. J Exp Psychol Hum Percept Perform. 1988;14:267-80. https://doi.org/10.1037/0096-1523.14.2.267
  13. Loetscher T, Lincoln NB. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database Syst Rev. 2013:CD002842.