Mirror Therapy for Hand Function Recovery in Acute Stroke

NCT ID: NCT07204067

Last Updated: 2025-10-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-15

Study Completion Date

2027-09-17

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Acute Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment (2 arms)
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants
None (Open Label)

Study Groups

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Mirror Therapy + Conventional Physiotherapy

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.

Group Type EXPERIMENTAL

Mirror Therapy Conventional Physiotherapy

Intervention Type BEHAVIORAL

Experimental: Mirror Therapy + Conventional Physiotherapy Mirror therapy performed 20 min/session, 2 sessions/week for 1 week. A mirror is placed midsagittal, reflecting the non-paretic limb while hiding the paretic limb. Patients perform bilateral movements (wrist, finger, elbow flex/extension; reaching/grasping) while focusing on the mirror image. This is followed by 20 min of conventional physiotherapy, including strengthening, functional tasks, theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, overhead reaching, and ball toss.

Active Comparator: Conventional Physiotherapy Only Conventional physiotherapy 20 min/session, 2 sessions/week for 1 week. Exercises include upper limb strengthening, functional task practice, theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, overhead reaching, and ball toss.

Conventional Physiotherapy Only

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.

Group Type ACTIVE_COMPARATOR

Mirror Therapy Conventional Physiotherapy

Intervention Type BEHAVIORAL

Experimental: Mirror Therapy + Conventional Physiotherapy Mirror therapy performed 20 min/session, 2 sessions/week for 1 week. A mirror is placed midsagittal, reflecting the non-paretic limb while hiding the paretic limb. Patients perform bilateral movements (wrist, finger, elbow flex/extension; reaching/grasping) while focusing on the mirror image. This is followed by 20 min of conventional physiotherapy, including strengthening, functional tasks, theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, overhead reaching, and ball toss.

Active Comparator: Conventional Physiotherapy Only Conventional physiotherapy 20 min/session, 2 sessions/week for 1 week. Exercises include upper limb strengthening, functional task practice, theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, overhead reaching, and ball toss.

Interventions

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Mirror Therapy Conventional Physiotherapy

Experimental: Mirror Therapy + Conventional Physiotherapy Mirror therapy performed 20 min/session, 2 sessions/week for 1 week. A mirror is placed midsagittal, reflecting the non-paretic limb while hiding the paretic limb. Patients perform bilateral movements (wrist, finger, elbow flex/extension; reaching/grasping) while focusing on the mirror image. This is followed by 20 min of conventional physiotherapy, including strengthening, functional tasks, theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, overhead reaching, and ball toss.

Active Comparator: Conventional Physiotherapy Only Conventional physiotherapy 20 min/session, 2 sessions/week for 1 week. Exercises include upper limb strengthening, functional task practice, theraputty squeezes, finger extension with rubber band, towel wringing, lifting small objects, overhead reaching, and ball toss.

Intervention Type BEHAVIORAL

Other Intervention Names

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intervention for stroke

Eligibility Criteria

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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
Minimum Eligible Age

40 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dr.Nadeem Ahmad, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Riphah international University Malakand Campus

Malakand, KPK, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Dr.Nadeem Ahmad, MS

Role: CONTACT

03451915105

Dr.Nadeem Ahmad, MS

Role: CONTACT

03028367237

Facility Contacts

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Dr.Nadeem Ahmad, MS

Role: primary

03451915105

Dr.Nadeem Ahmad, MS

Role: backup

03028367237

Other Identifiers

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RIPHAH-REC Sapna Kursheed

Identifier Type: -

Identifier Source: org_study_id

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