Combining Functional Electrical Stimulation with Mirror Therapy for the Upper Limb in People with Stroke

Abstract

This article explores the effects of combining functional electrical stimulation (FES) and mirror therapy for stroke rehabilitation of the upper limb and discusses the clinical implications of this new intervention. FES is used to assist in the retraining of motor function, through electrical stimulation, in patients with minimal or no voluntary muscle contraction. Mirror therapy in stroke rehabilitation involves the patient observing movements of their unaffected hand in a mirror; receiving the impression that the affected hand is moving. We performed a comprehensive search for studies based on the key words stroke, electrical stimulation, mirror therapy, combination and upper limb. The methodological quality of 14 studies was critiqued. Studies were assigned to 1 of 4 groups for analysis: passive, active-assisted, usual care, and imagery. The imagery group showed the most clinically significant results, with significant improvements in the Upper Extremity Fugl-Meyer measure when compared with control groups. Of these interventions, FES and mirror therapy were found to combine well by stimulating 3 separate sensory systems: vision, touch, and proprioception. Combining FES with mirror therapy may prove to be a powerful rehabilitation tool for the upper limb in people with stroke.