Effect of mirror therapy on hand function in patients with hand orthopaedic injuries: a randomized controlled trial

Purpose: To investigate the effects of mirror therapy (MT) in restoring hand function in patients with active range of motion (AROM) impairments following orthopaedic injuries. Method: In a randomized controlled trial (RCT), 30 patients with active ROM impairment (8 men and 22 women; mean age: 38 years) were measured. Intervention group received MT, 30 min a day, five days a week for three weeks, as well, half an hour conventional rehabilitation after each MT session. Patients in the control group received the same treatment programme, but instead of mirror, they observed directly the affected hand. In addition, both groups performed a 15 min home programme, including MT for intervention group and AROM with direct observation of the affected hand for control group, twice daily. Outcome measures, including total active motion (TAM) and Disabilities of Arm, Shoulder and Hand (DASH) questionnaire, were administered pre- and post-treatment and three weeks later. This study was registered as an RCT, no. NCT01503762 in http://clinicaltrials.gov/. Results: Final analysis was performed on 23 patients. The mean (SD) changes at post-test from baseline TAM was 154 (32) in the MT (N = 12) and 61 (24) in the control group (N = 11); mean difference (95% CI) 93 (68-118), p = 0.001. The mean (SD) change at post-test from baseline DASH was -34 (7) in the MT (N = 12) and -15 (11) in the control group (N = 11); mean difference (95% CI) 19 (-27 to -11), p = 0.001. Conclusions: Despite significant improvement at post-test in both groups and maintenance of improvement during the follow-up period, MT combined with conventional rehabilitation produced more improvement in hand function than control group.