Motor and Sensory Benefits of Mirror Therapy in Children and Adolescents with Unilateral Cerebral Palsy: A Systematic Review and Meta-Analysis

Abstract

Background: Mirror therapy (MT) creates a cerebral illusion of a normal movement in a paretic limb. Although mirror therapy has been studied as a suitable intervention for children with Unilateral Cerebral Palsy (UCP), a comprehensive understanding of its full range of benefits is still lacking. Thus, the aim of this systematic review and meta-analysis was to determine all motor and sensory effects of MT in children and adolescents with UCP. Methods: Clinical trials focused on the application of MT in the upper limb (UL) of children and adolescents with UCP were included. A search was performed in PubMed, Cochrane Library, Web of Science, and LILACS databases. Eleven studies were included in this systematic review. The PEDro scale and the MINORS scale were applied to evaluate the methodological quality of randomized and non-randomized controlled trials, respectively. The Risk of Bias tool was also employed to evaluate the potential bias. In addition, the TIDieR checklist was used to assess the quality of intervention reporting. A random-effects model was used for the meta-analysis. Results: The studies included children with UCP from three to eighteen years, classified in Manual Ability Classification System levels I–IV. Motor effects of MT were found in nine studies. Also, two studies reported sensory effects on registration, perception, and proprioception abilities. Qualitative and quantitative analysis showed that MT improved manual dexterity and tactile registration in children and adolescents with UCP. Conclusions: MT is a therapy capable of inducing motor and sensory improvements in the affected UL of children with UCP.