Does Mirror Therapy Improve Arm Function?

Mirror therapy (MT) is one of several effective treatments used to regain arm movement after a stroke.

Mirror Therapy Background

MT was originally designed to treat phantom limb pain with amputees. The way it worked was that it gave the person the sensation that they had to limbs. More recently this treatment was introduced in stroke rehabilitation with the hopes of tapping into this same phenomenon (give the brain the sensation of two functional limbs).

What is Mirror Therapy (MT)?

MT involves placing a mirror in the sagittal plane of the body to reflect an image of the uninvolved arm to the patient.

The patient is then asked to perform activities with both arms while watching the reflection of the uninvolved arm. I like to refer to this as “tricking the brain”, into thinking the involved arm is also performing the exact movement of the uninvolved arm.

What are some of the benefits of mirror therapy?

MT is not only proving to bee effective (which I will get to in the next section) but has other benefits as well that might place it ahead of other types of treatment. First, the cost of a mirror box is relatively cheap. So when comparing this to some other treatments such as body weight supported treadmill training and treatments using a mobile arm support, it is a no brainer that this is much more accessible to more stroke survivors.  Furthermore, remember that “brain trickery” I mentioned earlier? Well, since you are moving your unaffected arm and “tricking” your brain to believe you are moving your involved arm means that fewer manual cues and less assistance is required from the therapist. That being said, this can be performed more frequently than other forms of active assisted movements. That means more opportunities to tap into the benefits of neuroplasticity. Woo hoo!! Who doesn’t love an opportunity to get that brain re-wiring.

Is mirror therapy effective in improving movement in the arm and leg after a stroke?

So far, the data is promising with several recent articles reporting that, yes indeed, patients who have received MT are showing a clinically significant change in arm function. As far as the leg, there is less optimism in the research pointing to mirror therapy as an effective treatment to improve “functional leg movement”.

A cochrane review (a systemic review of health-related research topics) was published in 2018  that reviewed 62 relevant studies where at least one group of participants received mirror therapy. 57 of the studies were randomized control trials (one of the highest quality research studies) where at least. All of the studies combined included 1982 participants with a mean (average of all ages) age 59. Amongst the studies, mirror therapy was provided 15-60 min, 3-7 times per week.  The research studies were anywhere from two to eight weeks in length.

A 2010 study reported MT moderately improved movement in the arm and leg and the positive effects of the treatment remained for six months.

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