COMPARISON OF TASK ORIENTED APPROACH AND MIRROR THERAPY FOR POST STROKE HAND FUNCTION REHABILITATION

Abstract

Objective: The purpose of this study was to compare the effectiveness of task-oriented therapy and mirror therapy on improving hand function in post-stroke patients. Methods: Total subjects 30 were randomly divided into two groups: the task-oriented group (15 patients) and the mirror therapy group (15 patients). The task-oriented group underwent task-oriented training for 45 mins a day for 5 days a week for 4 weeks. The mirror therapy group underwent a mirror therapy program under the same schedule as task-oriented therapy. The manual dexterity and motor functioning of the hand were evaluated before the intervention and 4 weeks after the intervention by using FMA (Fugl-Meyer assessment) and BBT (Box & Block test). Results: Hand function of all patients increased significantly after the 4-week intervention program on the evaluation of motor function and manual dexterity by FMA and BBT in both the groups of Task-Oriented approach and Mirror therapy, but Group A Task-oriented approach improved more significantly when compared to Group B Mirror therapy. Conclusion: The treatment effect was more in patients who received a Task-Oriented approach compared to Mirror therapy. These findings suggest that the Task-Oriented approach was more effective in post stoke hand function rehabilitation. Keywords: Task oriented approach; Mirror therapy; Stroke hand function Introduction Stroke is the sudden loss of neurological function caused by an interruption of the blood flow to the brain. Ischemic stroke is the most common type of stroke, affecting about 80% of individuals, which results in the loss of essential oxygen and nutrients. Rupture of the blood vessels leads to Haemorrhagic stroke which in turn leads to leakage of blood in and around the brain. Stroke is a common neurological disease that leads to morbidity, mortality, and disability in the adult population. WHO defined stroke as “Rapidly developing clinical signs of focal disturbance of cerebral function; lasting more than 24 hours or leading to death, with no apparent cause other than the vascular origin [1]”. During the past 2 decades, the prevalence of stroke in India was estimated to range from 84 to 262 per 100,000 populations in rural areas to 334 to 424 per 100,000 populations in urban areas [2]. Loss of upper limb function is one of the major impairments following stroke. 83% of the stroke survivors remain independent in performing lower limb functional activities, whereas only 5-20% of the affected individuals remain independent in performing affected upper limb functional activities [3, 4]. Major disability following upper limb impairment is loss of hand function; it leads to the disrupted connection between hand muscles and brain which leads to spasticity. Loss of neural connections leads to difficulty in performing hand movements where, fully straightening the fingers, grasping an item, grip strength and all other functions of the hand remains difficult in performing [5]. This makes individuals difficulty in performing everyday tasks and remains dependent on functional activities. The task-oriented approach is defined as a ‘training or therapy where patient has to practice context-specific motor tasks and receive some form of feedback [6]; A task-oriented approach or therapy concentrates mainly on the improvement of the functional activities, therapy majorly concentrates on rega