Maximum tolerable daily dose of mirror movement therapy ankle exercises after stroke: an early phase dose screening study

Bajuaifer, Sarah, Grey, Michael J. ORCID: https://orcid.org/0000-0002-3216-3272, Hancock, Nicola J. ORCID: https://orcid.org/0000-0003-4850-3152, Chandler, Elizabeth and Pomeroy, Valerie M. ORCID: https://orcid.org/0000-0003-4487-823X (2024) Maximum tolerable daily dose of mirror movement therapy ankle exercises after stroke: an early phase dose screening study. Physiotherapy, 122. pp. 30-39. ISSN 0031-9406

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Abstract

Background: Mirror movement therapy may reduce lower limb motor impairment after stroke, but the optimal dose is unknown. Objective: identify the maximum tolerable dose a day (MTD) of lower limb mirror movement therapy. Design: 3+3 cohort rule-based, dose escalation/de-escalation study. After undertaking baseline measures participants performed mirror movement therapy for 14 consecutive days. Participants then undertook outcome measures. Cohort One trained for 15 minutes daily. Subsequent cohorts exercised at a dose set according to pre-set rules and the modified Fibonacci sequence. The study stopped when the difference between set doses for consecutive cohorts was 10% or less. Setting: Participants’ homes (intervention) and a movement analysis laboratory (measures). Participants: Adults discharged from statutory stroke rehabilitation services. Intervention: Mirror movement therapy ankle exercises. Outcome measures: Motricity Index (primary) and bilateral time symmetry from movement onset to peak activation of Tibialis Anterior muscles during standardised sit- to-stand (secondary). Results: Five cohorts of three participants were included (n=15). Mean (SD) age and time after stroke were 61 (9) years and 35 (42) months respectively. Set daily doses for the five cohorts were: 15, 30, 50, 40 then 35 minutes. The set dose for a subsequent cohort (six) would have been 38 minutes thus the difference from cohort five would have been three minutes i.e., 9% different. Therefore, the study stopped. Conclusion: The identified MTD of lower limb mirror therapy was 35 minutes daily when frequency was set at seven days a week and duration as two weeks.

Item Type: Article
Uncontrolled Keywords: stroke,mirror movement therapy,lower extremity,dose-response,stroke,dose-response,lower extremity,mirror movement therapy,rehabilitation,physical therapy, sports therapy and rehabilitation ,/dk/atira/pure/subjectarea/asjc/2700/2742
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 03 Nov 2023 03:22
Last Modified: 04 Mar 2024 18:21
URI: https://ueaeprints.uea.ac.uk/id/eprint/93548
DOI: 10.1016/j.physio.2023.10.007

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