# The Effectiveness of Combined Mirror Therapy and Contralateral Controlled Functional Electrical Stimulation Therapy in a Stroke Patient With Upper Limb Motor Paralysis: A Case Report

## TL;DR

A stroke patient with severe upper limb paralysis showed significant motor recovery using a combination of mirror therapy and electrical stimulation.

## Contribution

This case report introduces a combined therapy approach using mirror therapy and CCFES for severe upper limb motor paralysis.

## Key findings

- The patient's FMA-UE score improved from 17/66 to 52/66 over 16 weeks.
- MAL scores increased from AOU 1.5 and QOM 1.0 to AOU 3.6 and QOM 3.9.
- The combined therapy showed promise in enhancing motor recovery in severe stroke cases.

## Abstract

Severe upper limb motor paralysis following a stroke significantly limits patients' daily function and quality of life. While traditional therapies like constraint-induced therapy, muscle strengthening, and exercise are commonly used, they often lack effectiveness for severe cases due to their reliance on voluntary movement. In contrast, mirror therapy and contralaterally controlled functional electrical stimulation (CCFES) have shown potential by directly engaging neural pathways to promote recovery. This case report describes combining two methods to create a more effective approach for enhancing motor recovery in patients with severe upper limb deficits.

A 59-year-old Japanese male presented with left hemiplegia following a right subcortical hemorrhage. Following craniotomy and cranioplasty, he was transferred to our facility for rehabilitation. Upon initiation of occupational therapy, comprehensive assessments revealed profound motor impairments in the left upper extremity, with a Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score of 17/66 at the start of therapy and initial Motor Activity Log (MAL) scores of amount of use (AOU) 1.5 and quality of movement (QOM) 1.0 at week four. A combined regimen of mirror therapy and CCFES was administered over 16 weeks. During this time, the patient exhibited substantial improvements in motor function, with the FMA-UE score increasing to 52/66 and the MAL scores improving to AOU 3.6 and QOM 3.9 by week 16. This study suggests that a rehabilitation strategy combining mirror therapy with CCFES can effectively enhance motor recovery in patients with severe upper limb motor paralysis. However, these findings should be interpreted with caution as they are based on a preliminary single-patient case study. Further research with larger sample sizes is needed to confirm the efficacy of this combined approach and assess its long-term benefits.