Comparison of Mirror Therapy and Task-Specific Training on Upper Limb Function in Post-Stroke Patients With Shoulder Pain

Abstract

Background: Stroke is a leading cause of adult disability worldwide, often resulting in upper limb motor deficits and shoulder pain that significantly impair daily function and quality of life. Despite various rehabilitation strategies, comparative evidence on the standalone effectiveness of mirror therapy (MT) versus task-specific training (TST) in this population remains limited. Objective: This study aimed to compare the effects of mirror therapy and task-specific training on upper limb motor function, shoulder pain, and muscle strength in post-stroke patients with shoulder pain, hypothesizing that TST would yield superior outcomes. Methods: A single-center, randomized controlled trial was conducted involving 36 post-stroke patients (n = 36) aged 39–67 years, with stroke onset between 3–12 months, Fugl-Meyer Assessment (FMA) scores of 20–50, and shoulder pain rated ≥4 on the Visual Analog Scale (VAS). Participants were randomly allocated to receive either MT or TST for 30-minute sessions, three times weekly for 8 weeks. Outcome measures included FMA (primary), VAS, and Manual Muscle Testing (MMT) for shoulder abduction, elbow flexion, and wrist extension. Ethical approval was obtained from the Research and Ethics Committee at Government College University, Faisalabad (Ref: GCUF/ERC/24/2465), and informed consent was secured in compliance with the Declaration of Helsinki. Data were analyzed using SPSS v25 with paired t-tests, independent t-tests, and Mann-Whitney U tests where appropriate (p < 0.05). Results: Both groups showed significant pre–post improvements in FMA, VAS, and MMT (p < 0.001). Post-intervention analysis revealed significantly higher FMA scores (43.89 ± 2.70 vs. 38.00 ± 3.03), lower VAS scores (2.56 ± 0.51 vs. 3.78 ± 0.81), and better shoulder abduction strength (p = 0.047) in the TST group compared to the MT group. No significant differences were noted for elbow flexion (p = 0.279) or wrist extension (p = 0.406), though both improved clinically. Conclusion: Both mirror therapy and task-specific training significantly improved upper limb function and reduced shoulder pain in post-stroke patients; however, task-specific training demonstrated superior functional and pain-related outcomes. These findings support the integration of TST as a primary rehabilitation strategy and highlight its practical utility in neurorehabilitation settings.