How to treat stroke patients is one of the most important issues today for those who are concerned with the health of the global population. Strokes can occur at any age, but they typically afflict the elderly and lead to paralysis, lost speech as well as mental illness and many other problems. At the moment the planet faces a rapidly ageing population as more and more people around the world live to their 70s, 80s and 90s. Because of this it is vital that as much research as possible is carried out on the treatment of those who suffer from a stroke.
Not only is the number of these people likely to increase exponentially as the population and average age of the planet rises, but effective stroke treatment and therapy can make the difference between an old age spent in misery and one in which a person is able to live happily and to live as they have done for much of their previous life. Mirror therapy is a simple and pain free procedure through those who have suffered a stroke are able to regain movement in affected limbs. This semester I intend to study mirror therapy and to understand the ways in which it can be seen to be a vital part of stroke rehabilitation treatment. This paper will show that this is case by first of all giving an outline of what the therapy entails and then considering research which proves its effectiveness.
Mirror therapy for stroke patients is a form of post-stroke ehabilitation which help those who have suffered a stroke to retrain their brain to able to perform tasks which they have lost the ability to perform. One leading expert in the field has described how the treatment fits in with existing research and neuroscience. She writes;
‘Mirror box therapy is part of the new Graded Motor Imagery therapies resulting from research on brain activity and brain remapping. After a stroke or any kind of brain damage, the brain begins to remap itself, sometimes incorrectly. If incorrect brain mapping can be prevented, the patient has a much better chance of recovery’ (Beaumont, 2013).
A stroke occurs when a blood clot forms in the brain and deprives a certain part of it of oxygen. It only takes a very short amount of time for areas of the brain to begin to die should this happen, therefore people lose abilities associated with these areas. In order to compensate for this, a human brain effectively attempts to re-wire itself. Mirror therapy can be seen to be a scientific guidance of, and intervention in, this process of re-mapping.
The treatment itself is entirely none invasive and involves the use of mirrors in order to attempt to convince a the brain that a patient is moving a different limb from one that they are actually moving. For example, a person may have one hand that has been weakened by a stroke. During the treatment, they will sit a desk and practice moving their strong hand. The position of the mirror creates the effect that they are in fact moving their weak hand as well. After several treatments it has been shown that this can greatly increase the brain’s capacity to re-map itself in an effective way and to allow people to regain movement and actions in limbs and hands which would previously have been considered useless to them.
The results of mirror treatment are not necessarily miraculous. Several studies have shown that it does not produce significantly more powerful results than other forms of treatment. One study notes simply that the ‘administration of mirror therapy early after a stroke is not superior to conventional treatment in improving lower limb motor recovery and balance, except for improvement in mobility’ (Mohan, 2013). Other studies have shown similar results and no individual or organisation have suggested that mirror therapy should be taken as a standalone treatment. However, it has been argued that the therapy itself can provide an excellent, and entirely pain free complement to existing therapies such as physio therapy and other techniques used to regain strength after a stroke. When combined with physical therapy, mirror therapy can be highly effective. A study conducted by Ramachanran and Altschuler stated that ‘many patients show substantial recovery of function [in limbs damaged by strokes] using MVF’ (2009, 1700).
The effectiveness of the therapy is also dependent on how severe the stroke which the patient has suffered is. Mirror therapy can do little to aid severe strokes and complete paralysis, however, it has been shown to be able to aid those suffering from less severe weakness in their limbs. Crucially, it has also been described as possessing other advantages. Not only is it an extremely cheap form of treatment, but it also helps to make the patient feel as if they are taking an active role in their treatment. They are able to effectively participate in their own treatment and are able to watch themselves actively working for improvement. It has been noted by several commentators that this has a large effect on the way that overall treatment is experienced and on the recovery rates of such treatments. Thieme (2014, 30) writes that for mirror therapies studies, ‘the results indicate evidence for the effectiveness for improving upper body mobility, self-confidence, depression as activities of daily living and pain’.
Thieme, Ramacharan and the Beaumont hospital show that significant improvement is made in recovery, however the latter two sources also show that this treatment should be complemented by physio-therapy and other treatments and that mirror box therapy on its own is not likely to be an effective treatment for stroke related damage. It seems that there is a point of disagreement here, as the Beaumont hospital is much more encouraging regarding the singular effects of mirror box therapy. However, it remains the case that all three sources can be can be seen to be a part of a general trend of acceptance of the belief that mirror box therapy is able to provide a good service to those who have suffered stroke damage.
In conclusion, I have made an argument for the continued use of mirror therapy in the treatment of those who have suffered from strokes. I have made this argument because, first and foremost, the ageing global population means that more and more people will suffer from strokes and the most amount of time possible should be devoted to research in to treatment. Mirror therapy is not a miracle cure, and should be complemented by other therapies. However, it does posses unique potential and the possibility of a holistic and empowering experience of treatment. This means that the therapy should be subject of more research and that it should certainly continue to be administered where appropriate.
