Can Mirror Visual Feedback Improve Motor Outcomes after Nerve Repair? A Randomized Controlled Trial

Restoration of motor and sensory functions in the hand after nerve repair is a complex process based on multi-level cellular, chemical, and functional changes occuring from finger tips to cerebral cortex. The aim of the present study was to determine the effect of Mirror Visual Feedback (mirror therapy) on improving motor outcomes after median /ulnar nerve repair.
A total of 20 patients (18 men, 2 women; mean age: 28 years) with acute complete ulnar, median, or combined median and ulnar nerve transections at the distal forearm level participated in the present randomized controlled trial study. Experimental group received the mirror therapy program for 15 minutes per day in addition to the traditional rehabilitation program, 5 days a week for 4 weeks, while control group received only the traditional rehabilitation program. Outcome measures including Total Active Motion (TAM), Opposition grade, Purdue pegboard test, and Box and Block Test were given prior to (4-6th week after surgery), and after (12th week after surgery) the treatment.
The final analysis was performed on 14 patients. The AROM of fingers, opposition and dexterity significantly improved in the post-test in both groups; however, there were no significant differences between the two groups. However, the results of Box and Block test revealed more improvement in the experimental group (p=0.06).
Based on statistical analysis, Mirror therapy, in combination with the traditional rehabilitation program, has no significant effect on motor outcomes improvement, compared with that on the control group. But, the results suggest that mirror therapy is effective in improving the dexterity and Active Range of Motion.