Effectiveness of Mirror Therapy vs. Conventional Therapy in Improving Upper Limb Function after Stroke

Abstract

Background: Stroke is a leading cause of long-term disability worldwide, with upper limb dysfunction being one of its most disabling sequelae. Conventional rehabilitation often yields incomplete recovery, prompting exploration of novel adjunctive approaches. Mirror therapy has emerged as a low-cost intervention targeting neuroplasticity, but evidence remains inconsistent, particularly in low-resource settings. Objective: To evaluate the effectiveness of mirror therapy compared with conventional therapy in improving upper limb motor recovery, functional independence, and spasticity among post-stroke patients. Methods: This single-blind randomized controlled trial was conducted at a rehabilitation clinic in Lahore, Pakistan. Sixty stroke survivors with unilateral upper limb paresis were randomized equally to mirror therapy or conventional therapy. Both groups received 30-minute intervention sessions, five times weekly for six weeks, with standardized functional task practice included. Outcomes assessed at baseline, six weeks, and three months included Fugl–Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Barthel Index (BI), and Modified Ashworth Scale (MAS). Analyses followed the intention-to-treat principle using repeated measures ANOVA and linear mixed models. Results: Mirror therapy resulted in significantly greater improvements in FMA-UE (mean 49.1 vs. 41.2, p = 0.001), ARAT (42.1 vs. 33.9, p = 0.001), and BI (81.1 vs. 70.4, p = 0.001) at three months, with larger effect sizes across outcomes. Spasticity reduction was also more pronounced (MAS 1.0 vs. 1.5, p = 0.003). Conclusion: Mirror therapy is superior to conventional therapy in enhancing motor recovery, functional independence, and spasticity reduction after stroke. Its simplicity and cost-effectiveness support its integration into routine rehabilitation, particularly in resource-limited healthcare systems.