Ask an answerable question (PICO)：
Non-invasive, activity-based therapies are regularly employed to address limb weakness resulting from stroke and to improve affected motor functions. In this study, evidence-based methods were used to investigate the effect of mirror therapy in improving upper limb motor function in patients with stroke, with the findings providing a reference for nursing practice.
The Method and Analysis of Literature Review：
A search of the literature was conducted using five databases, including Cochrane Library, PubMed, CINAHL, Medline, and Airiti Library. Search conditions set no restrictions on time period or language of publication and captured all potentially relevant studies published up to and including January 2024. Based on the study question, the search keywords used included: [P] stroke, [I] mirror therapy, [C] sham therapy (i.e., routine care), and [O] upper limb motor function. After searching for synonyms using MeSH terms, the keywords, synonymous MeSH terms, and truncation terms were all used to search each PICO keyword, with Boolean logic used to respectively combine and intersect keywords using “OR” and “AND”. Of the 228 potentially relevant articles screened, 225 were excluded for the following reasons: non-systematic study, randomized trial, meta-analysis, noncompliance with PICO, outdated, and duplicate study. Thus, three valid studies, including one systematic literature review and meta-analysis and two randomized controlled trials, were used in this assessment.
Critical Appraisal：
The 2024 version of the Critical Appraisal Skills Programme (CASP) was applied to assess the quality of the three included studies. In terms of reported results: (1) The systematic review reported mirror therapy as more effective than sham therapy in promoting upper limb motor function recovery in patients with stroke and (2) The findings of the two randomized trials indicate mirror therapy has a significantly stronger improvement effect on upper limb motor function than general conventional treatment in patients with stroke.
Results, Conclusions and Recommendations：
The findings of the systematic literature review and meta-analysis indicate upper limb motor recovery in patients in the subacute stroke stage receiving mirror therapy was better than in their peers who received sham therapy. However, the difference in improvement between these two groups did not reach statistical significance. Notably, the significant improvement in upper limb motor function observed in both randomized controlled trials on patients with stroke confirmed the effectiveness of this treatment modality. Future research should recruit larger sample sizes, optimize the trial design, reduce risk of bias, and conduct observations over longer time periods to investigate the sustained effects of mirror therapy and factors influencing the effectiveness of this therapy in different populations.
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