The efficiency of mirror therapy on drop foot in Multiple Sclerosis Patients

Although the effectiveness of mirror therapy (MT) has been proved in stroke persons, there is no scientific evidence about the results in people with Multiple Sclerosis. The aim was to investigate whether adding MT to exercise training and neuromuscular electrical stimulation (NMES) has any effect on clinical measurements, mobility and functionality in people with Multiple Sclerosis (MS). METHODS Ambulatory people with MS, with unilateral drop foot were included. MT group (n=13) applied bilateral ankle exercise program with mirror following NMES for 3 days a week at hospital and exercise program for 2 days a week at home. Control group (n=13) performed same treatment without mirror box (6 weeks). The later 6 weeks both groups performed only exercise program. Clinical measurements included proprioception, muscle tone of plantar flexor muscles (MAS), muscle strength of dorsiflexor, ankle angular velocity, range of motion (ROM) of ankle. Functionality (Functional Independence Measurement-FIM), mobility (Rivermead Mobility Index-RMI), ambulation (Functional Ambulation Scale-FAS), duration of stair climb test, and 25 feet walking velocity were assessed at the beginning, in 6th and 12th weeks. RESULTS More positive improvements were obtained in MT group than control group in terms of range of motion (0.012), muscle strength (0.008), proprioception (0.001), 25-feet walking duration (0.015), step test duration (0.001), FAS (0.005), RMI (0.001) and FIM (0.001) after 6 weeks treatment. It was seen that this improvement maintained to 12th week on all clinical and functional measurements (p<0.05). CONCLUSION The trial revealed that adding MT to exercise training and NMES has more beneficial effects on clinical measurements, mobility and functionality in people with Multiple Sclerosis with unilateral drop foot.