Article Critique Mirror Therapy
The article by Derakhshanrad et al. (2007) sought to examine the effectiveness of mirror therapy on the upper limb function. The article’s introduction has given a clear explanation of the therapy and theoretical model it will use. The authors explain that mirror therapy is a technique that uses a mirror placed between two limbs of movement of the non-affected limb superimposed on the contralateral affected limb. It is purported that therapy is useful in improving the motor function of adults who have suffered a stroke or children with spastic hemiparetic cerebral palsy. The objective of the study by Derakhshanrad et al. (2007) was to understand the mechanism mirror therapy using the rehabilitation method and neuro-occupation. The second objective was to analyze the effects of the therapy on the subjects’ upper limb function with cerebral palsy.
The study has hypothesized that the brain might benefit from the feedback received from the mirror therapy resulting in the increased excitability of the primary cortex of the brain’s affected hemisphere. The study has also identified the conceptual; model/ theoretical framework that it used. The study uses the Neuro-occupation Model, a theoretically driven model, to explain the mechanism of the underlying clinical effects of mirror therapy. The research question stated in the study asks whether the Neuro-occupation model can explain the link between mirror-visual feedback and the upper limb control motor.
The study’s methodology utilized a single-subject design. Specifically, the study uses the A-B-A single-subject design, also known as a reversal design, and involves discontinuing the intervention and returning to a non-treatment condition. Alnahdi (2013), who examined the single-subject design, noted that flexibility and cost-effectiveness were the main advantages. Alnahdi, however, indicated that external validity and generalizability are the main concerns. The sample size used in the study involved four participants, three of whom were males, and one was female. The inclusion criteria described for the sample of participants involved six factors. Some of these criteria include that participants be aged between 5 and 15 years, cognitively oriented, diagnosed with spastic hemiparetic cerebral palsy, not treated with botulinum toxin in the past six months prior to the study and be willing to participate. The study also identified critical exclusion criteria. The intervention used in the study is the mirror therapy. The study has clearly explained a home-based mirror therapy that it instructed participants to do in a daily 20-minute session. The method which altered the mirror-visual feedback, which is the independent variable to measure the improvement in upper motor function, which is the dependent variable. The outcomes were measured using the Box and Block Test. Higher scores in the test indicated a better functional status.
The study considered ethical issues. The ethical committee approved the trial of the Shiraz University of Medical Sciences. Additionally, prior to the study, participants, as well as their family, were informed about the research and possible risks and benefits. The family gave consent for their children to participate in the study.
In the ten-week period that the study took place, the participants demonstrated an ability to perform the box and block test, stack rings, and to thread bids in the treatment phase. However, the graph presented showed a decline in these abilities in the withdrawal phase. The study confirmed earlier studies which showed the mirror therapy has a promising therapeutic effect on hand function. The study confirmed the hypothesis arguing that the sensory disturbances of the mirror reflection therapy was effective in bringing the participants to start of readiness as they responded positively to the destabilization of their sensory cortices.
The study has several limitations. The study utilized a small number of participants and use a few of the motor assessments to gather data. Additionally, the study did not collect data from children and their parents. This shows that the data used in the study is limited hence inability to generalize the study. However, the outcomes of the study have implications to social workers and nursing professions. Nurses and social workers can administer the mirror therapy on the patients who have had stroke or children with cerebral palsy as it has shown promise in the ability to regain motor function. Future studies should overcome the limitation of this study and ensure that the outcomes are sustainable even after withdrawing the therapy.
Overall, the article is straightforward from the abstract to the conclusion. The article achieved its goal of examining the effect of motor therapy on upper limb function. For colleagues that encounter such clients I would recommend the article to them. The endorsement of the article is informed by the fact that the research is peer reviewed, used the proper method in data collection and analysis and is current. The authors of the article also have authority on the topic given that three of them are affiliated to the Shiraz University of Medical Sciences, Iran while the other is affiliated to the University of Texas, US.