Quality of life is affected in patients of MCA stroke due to continuous motor limitations of hand. We have developed customized mirror therapy with object on paretic hand to promote hand function and grip in patients with MCA stroke. To analyze the effectiveness of CMT with object on paretic hand in improving gross motor hand function and handgrip strength in patients with MCA stroke. Six patients with hemiparesis after MCA stroke were included in this pretest-posttest quasi experimental. Standardized hand exercises were performed in a customized mirror box with bilateral hands for 20 intervention sessions in addition to regular physiotherapy. All participants were assessed for Michigan hand outcome questionnaire, handgrip strength with sphygmomanometer and Brunnstrom grades of hand recovery stages at baseline, 2^nd week and 4^th week of intervention. Age, height, weight and BMI of six P-MCA stroke recruited were, 64.5 (48.5-70.9) years, 159.9 (153.1-167.9) cm, 56.8 (50.4-63.9) Kg, and 22.3 (18.6-26.1) Kg/m2 respectively. Significant changes were noted when measured at 2^nd and 4^th week in Michigan hand outcome questionnaire (p=0.011), handgrip strength (p=0.017) and, Brunnstrom hand recovery stages (p=0.007). Customized mirror therapy with object on paretic hand might be a feasible intervention in improving gross motor hand functions and handgrip strength of P-MCA stroke.

Stroke is the second reason for increasing death rate and third reason for increasing disability rate. Dexterity skills are required to perform activities of daily life and these are affected by continuous motor limitation of hand in stroke. Dexterity skills mean the potential of a person to grasp and manipulate things by precise hand and finger movement. Manipulation of an object is influenced by weakness of wrist extensors, finger and thumb flexors, extensors, adductors and abductors. Overall, health status of elderly individuals are represented by their handgrip strength. Patients with stroke have difficulty in holding and controlling grip force during grabbing and lifting the object. This affects the Activities of Daily Living (ADL) to the greater extend. Recent study on mirror therapy supports improvement in Brunnstrom stages and functional activities of hand in patients with stroke. Exercise performing in front of mirror box excite the mirror neuron system which contains visuomotor neuron. Mirror therapy helps in regaining motor functions, ADL, sensation loss, phantom pain, visuospatial neglect, etc. The basic principle of mirror therapy is that non-hemiparetic limb image is used to regain motor activities and remove burning, prickling, tingling sensations. Visual feedback helps in inducing neuroplasticity to produce recovery due to stimulation of the cerebral hemisphere.

With Regards,
Sara Giselle
Associate Managing Editor
Journal of Stroke Resarch & Therapy