Statistics
Hemiplegia is often a result of a stroke or brain disease. Data shows that in China, there are more than seven million stroke survivors with approximately 70% of them experiencing functional disabilities [7]. Statistics show that about 10% of stroke patients fully recover, about 25% mostly recover with some minor problems, and 40% are partially recovered and require some amount of assistance. Of the remaining, 10% become severely impaired and need long term care while 15% do not survive [8]. Strokes are among the most common causes of adult-onset disability and 70-85% of patients experiencing first strokes become hemiplegic afterwards. Of those that have hemiparesis, only about 60% can recover basic activities and motor skills [9].
Treatments
Mirror Therapy
Mirror therapy is a current treatment that is designed to help patients recover from hemiplegia after having a stroke. To successfully complete mirror therapy, the patient is given a mirror to put between both upper limbs to see the unaffected limb moving in the mirror as if it is the affected limb [10]. This type of therapy is implemented into stroke patients’ recovery as it is shown to help spark the process of neuroplasticity in the brain, which, in short, means that the brain is tricked into thinking that the affected limb is moving when it is not [11]. In a recent study from the Hong Kong Journal of Occupational therapy, an analysis was done on four patients that underwent 23 sessions of mirror therapy. During this study, the patients were required to use simple upper limb movements in front of the mirror to regain motor function of the hemiplegic limb. After the 23 sessions concluded, the results were that upper extremity function had improved significantly from the therapy. However, the progress and improvements were not maintained after the therapy session concluded [12]. Currently, mirror therapy needs to be continued for some time before results can be seen and maintained, but further studies and research can improve the inner workings of this treatment.
Mental Imagery
Mental imagery is an existing treatment that is often called mental practice [4]. This treatment has been proven to help with activating parts of the brain responsible for movement by inducing an imaginary movement or skill to perfect an action after a stroke. Through clinical trials and research, it has been concluded that the mental practice treatment is more effective when paired with conventional physical therapy, with one helping with muscle recovery and one with muscle movement. In the research paper, 23 clinical trials were selected to be analyzed. In these trials, the hemiplegic patients had an improvement in both their upper and lower limbs that had previously been weakened from a brain disease or stroke [13]. Many of these patients were able to recover their daily activities and skills but since each patient has a different level of motor loss, further studies are necessary to determine the optimal treatment process.
Electrical Stimulation
Another existing treatment is electrical stimulation, where electrical pads are used to contract muscles that can’t be moved consciously [14]. Based on a previous research paper published in 1950 about a single-channel functional electrical stimulation (FES) system, this paper [15] analyses the effects of dual-channel FES in patients with hemiparesis. In hemiplegia, there is normally complete paralysis of a limb but in hemiparesis, there is only partial weakness. Since hemiplegia can be a worse condition of hemiparesis, research done on patients with hemiparesis can be further developed to eventually help patients with hemiplegia. The research done in 1950 involved using the single-channel FES system to treat patients with hemiplegia experiencing foot drop, a condition when a patient is having difficultly lifting the front part of their foot. Springer’s research used to FES treatment on the thigh muscles to help with gait and lower limb recovery. While the studies worked, further research is needed to address other variables in such an individualized treatment. There were some biases found among the patients in the study due to a lack of variability and overall number of patients, but after the dual channel FES treatment, all the patients were able to walk. It was concluded that future research can compare the effectiveness between thigh FES and peroneal FES for better results.