Clinical feasibility and cortical effects of synchronous mirror therapy on speech-language and upper limb motor function after stroke.

Background: Post-stroke aphasia concurrent with upper limb (UL) motor dysfunction is very common and difficult to rehabilitate. Although mirror therapy (MT) has demonstrated efficacy in treating aphasia and UL motor dysfunction separately, it has not been utilized to address both conditions simultaneously. Our study introduces a novel Synchronous Mirror Therapy (SMT) system that integrates speech-language therapy with UL motor training to evaluate its clinical feasibility, preliminary efficacy, and potential cortical mechanisms.

Method: Fifteen patients and five therapists participated in this study. The patients had aphasia and UL motor dysfunction and underwent the SMT intervention ten times. They were evaluated through functional assessment scales (Aphasia Quotient of Western Aphasia Battery (WAB-AQ); Assessment of Fugl-Meyer Upper Limb scale (FMA-UL); Action Research Arm Test (ARAT)) and three questionnaires, and functional near-infrared (fNIRS) test. We analyzed the questionnaire results, functional changes before and after SMT, and differences between the SMT intervention and rest periods.

Results: Nine patients underwent all SMT treatment sessions. Patients and therapists gave high ratings for SMT. Compared with before SMT interventions, significant improvements were observed in language function (WAB-AQ:  = 0.008) and UL motor function (FMA-UL:  = 0.007; ARAT:  = 0.016) after all SMT interventions, along with significant changes in three fNIRS channels (channel 9,  < 0.001; channel 20,  = 0.005; channel 30,  = 0.046) during the SMT intervention.

Conclusion: The SMT intervention demonstrated feasibility and received positive feedback from both patients and therapists. The results indicate potential benefits of SMT in improving language and UL motor function for post-stroke patients. fNIRS findings suggest possible enhanced cortical activation during SMT, which may be associated with neural recovery processes. While encouraging, this still necessitates validation through larger sample sizes and rigorous randomized controlled designs.