Video Based Behavioral Analysis to Observe Attention during Mirror Therapy in Hemiplegic Patients : Preliminary Study

Objective: Mirror therapy is one of the promising methods suggested for the upper limb rehabilitation of stroke patients. Whilemirror therapy was presented to be effective in improving motor function of stroke patients, problems were raised as precedingstudies had various methods in applying mirror therapy. Some studies even reported no effect in mirror therapy. Our suppositionfor the reason of such problems was a decrease of attention on the illusive image during mirror therapy of stroke patients, and we aimed to observe this. Design: A cross-sectional preliminary study. Methods: Three hemiplegic acute patients were recruited for the traditional mirror therapy. It lasted for 30 minutes, and 12different tasks were asked to perform. All procedures were video-recorded, and Observer XT was used to analyse mirror-gazingtime, gaze-distracted time, preparation time, frequency of mirror gazing, frequency of distraction, frequency of preparation fortreatment. Results: Subjects spent an average of 4-5 minutes having instructions about the mirror therapy intervention (preparation duration), an average of 11 minutes watching the mirror during therapy (mirror-gazing duration), and the rest of 14-15 minutes lookingaround the environment (gaze-distracted duration). During the mirror therapy, the number of distracted moments (frequency ofdistraction) was eight times more than focusing on the mirror (frequency of mirror gazing). Conclusions: Once the patient looks at the mirror, it only lasts about 5 seconds on average. Thus, we confirmed that patients couldnot concentrate on the illusion during the session and therefore it may have affected the effectiveness of the therapy.