Mirror Therapy for Hand Function Recovery in Acute Stroke

Riphah International University

Status: Enrolling

Conditions: Acute Stroke

Treatments: Behavioral: Mirror Therapy Conventional Physiotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07204067

RIPHAH-REC Sapna Kursheed

Details and patient eligibility

About

Randomized controlled trial to determine whether mirror therapy (MT), added to conventional physiotherapy, improves upper-limb motor recovery, hand function, spasticity, and range of motion (ROM) in acute stroke compared with conventional physiotherapy alone. Outcomes include ARAT, Motor Assessment Scale, Modified Ashworth Scale, and goniometric ROM.

Full description

Stroke causes significant upper-limb impairment in the acute stage; early, targeted rehabilitation leverages heightened neuroplasticity. Mirror therapy uses a mid-sagittal mirror to reflect movements of the non-paretic limb, creating the illusion of normal movement in the paretic limb, recruiting mirror neuron circuits and facilitating motor relearning. Prior work suggests MT can improve fine and gross motor skills, reduce spasticity, and increase active ROM. This trial operationalizes a pragmatic MT protocol integrated with standard inpatient/outpatient physiotherapy in acute stroke.

Enrollment: 44 estimated patients

Sex: All

Ages: 40 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 40-55 years
• Acute ischemic or hemorrhagic stroke within the last 1 month
• Unilateral hemiparesis/hemiplegia
• Medically stable and cleared for rehabilitation
• Able to follow verbal instructions; MMSE ≥ 24
• Provides written informed consent

Exclusion criteria

• Recurrent stroke or bilateral involvement
• Severe cognitive impairment (MMSE < 24)
• Visual field deficits, unilateral neglect, or severe aphasia interfering with MT
• Other neurological disorders (e.g., Parkinson's, MS)
• Orthopedic conditions affecting upper limb/trunk
• Uncontrolled cardio-respiratory disease limiting exercise
• Severe spasticity (MAS ≥ 3) in affected limb
• Concurrent enrollment in other interventional trials
• Inability/refusal to consent

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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44 participants in 2 patient groups

Mirror Therapy + Conventional Physiotherapy

Experimental group

Description:

Experimental: Mirror Therapy + Conventional Physiotherapy Device/Procedure: Mirror Therapy (20 min/session) + immediate Conventional Physiotherapy (20 min/session) Schedule: 2 sessions/week for 1 week (total: 2 sessions) MT Procedure: Mirror (box or plain) placed along mid-sagittal plane reflecting the non-paretic limb while hiding the paretic limb. Participants perform bilateral symmetrical movements focusing on the mirror image (e.g., wrist flex/ext, finger flex/ext, elbow flex/ext, reaching \& grasping). Conventional Content (immediately after MT): strengthening \& functional task practice (e.g., reaching/transfers), plus targeted hand training: theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, reaching overhead/side-to-side with weight, weighted ball toss/catch.

Treatment:

Behavioral: Mirror Therapy Conventional Physiotherapy

Conventional Physiotherapy Only

Active Comparator group

Description:

Procedure: Conventional Physiotherapy (20 min/session), no mirror. Same schedule and exercise menu as above without visual mirror feedback. Notes: The proposal specifies 1 week duration with 2 sessions/week, 20 min each; centers may extend to clinically standard dosage via protocol amendment if needed.

Treatment:

Behavioral: Mirror Therapy Conventional Physiotherapy