Mirror Therapy for Stroke Rehabilitation

(MiraPi Trial)

Overseen By Gregory Roytman

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Yale University

Disqualifiers: Spasticity, Minors, Vulnerable populations, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 2-3 weeks

50 Participants Needed

Trial Summary

What is the purpose of this trial?

This is a randomized controlled trial which will compare conventional mirror therapy with mirror therapy using the Miraπ device which physically moves a patient's affected limb. This study will use two parallel groups: (1) receiving conventional mirror therapy as a part of the standard of care as conducted by the participant's clinical care team and (2) receiving mirror therapy with the Miraπ device as conducted by study personnel with the oversight of the participant's clinical care team.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Miraπ, Mirror Therapy for stroke rehabilitation?

Research shows that mirror therapy can help improve movement, balance, and mobility in people recovering from a stroke. It involves using a mirror to trick the brain into thinking the affected limb is moving, which can aid in recovery. ^{1 2 3 4 5}

Is mirror therapy safe for humans?

Mirror therapy is generally considered safe for humans, as it involves simple movements of the unaffected limb while watching its reflection, which poses minimal risk. ^{1 2 3 4 6}

How is mirror therapy different from other stroke rehabilitation treatments?

Mirror therapy is unique because it uses the reflection of the unaffected limb in a mirror to create the illusion that the affected limb is moving, which can help improve motor function after a stroke. This approach is relatively new, easy to access, and can be self-administered at home, making it different from more traditional rehabilitation methods. ^{1 4 5 7 8}

Research Team

Necolle Morgado-Vega

Principal Investigator

Yale University

Eligibility Criteria

This trial is for individuals who have experienced a stroke and are dealing with pain or weakness as a result. Participants should be under the care of a clinical team and willing to undergo mirror therapy, either conventional or using the Miraπ device.

Inclusion Criteria

I am approved for inpatient rehabilitation by the medical director.

My doctor has approved mirror therapy for my rehabilitation.

I have paralysis or trouble moving only one of my hands.

Exclusion Criteria

I am not medically cleared for standard inpatient rehab therapies.

I am under 18 years old.

Vulnerable populations

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive either conventional mirror therapy or mirror therapy using the Miraπ device for 15 minutes daily, 3 days per week until discharge

2-3 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Miraπ
• Mirror Therapy

Trial Overview The study compares two types of mirror therapy: traditional mirror therapy provided by participants' own healthcare teams versus innovative Miraπ-assisted therapy overseen by study personnel in collaboration with those teams.

Participant Groups

Group I: Miraπ Group Experimental Treatment 1 Intervention

Participants in this group will train with the Miraπ device, performing it on the affected arm for 15 minutes daily, 3 days per week until their discharge from clinic (approximately 2-3 weeks).

Group II: Conventional Therapy Group Active Control 1 Intervention

Participants in this group with train using Mirror Therapy (MT), the current standard of care, performing it on the affected arm for 15 minutes daily, 3 days per week until their discharge from clinic (approximately 2-3 weeks).

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

Findings from Research

Mirror therapy, when combined with conventional rehabilitation, significantly improves motor function in stroke patients, as shown in seven randomized controlled trials with medium-high methodological quality.

While there are positive results regarding the effect of mirror therapy on hemineglect, the evidence is limited and inconclusive due to the small sample sizes in the studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Mirror therapy in hemiplegic patient]. Lisalde-Rodríguez, ME., Garcia-Fernández, JA.[2016]

Mirror therapy (MT) significantly improved movement performance and motor control in chronic stroke patients, as evidenced by better scores on the Fugl-Meyer Assessment and faster reaction times compared to control treatment (CT).

While MT enhanced sensory recovery, particularly in temperature sense, it did not lead to significant improvements in daily functioning as measured by the Motor Activity Log and ABILHAND questionnaire.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of mirror therapy on motor and sensory recovery in chronic stroke: a randomized controlled trial. Wu, CY., Huang, PC., Chen, YT., et al.[2016]

Mirror therapy (MT) significantly improves lower-limb motor recovery, balance, and gait in subacute and chronic stroke patients, with a notable effect size for motor recovery (SMD 0.59) and gait (SMD 1.13) based on a review of 10 studies.

MT can be effectively implemented as a standalone treatment for 30 minutes a day, 5 days a week for 4 weeks, and may also be combined with electrical stimulation to enhance gait recovery, particularly in patients without severe cognitive disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of mirror therapy on lower limb motor recovery, balance and gait in subacute and chronic stroke: A systematic review. Kundi, MK., Spence, NJ.[2023]

In a study involving 37 stroke survivors, those who practiced mirror therapy with action observation (AO) showed a significant 18.3% reduction in movement time for reaching tasks, compared to a 9.1% reduction in the control group observing static images.

The results indicate that mirror therapy-based AO is more effective for improving motor learning in the affected arm after a stroke, as evidenced by a statistically significant greater decrease in movement time compared to the control observation group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Mirror Therapy-Based Action Observation Protocol to Improve Motor Learning After Stroke. Harmsen, WJ., Bussmann, JB., Selles, RW., et al.[2016]

A self-administered home-based mirror therapy program, practiced for 5 weeks with an average of 39.23 minutes per day, was feasible for a stroke patient and led to improvements in upper extremity function.

The participant showed significant enhancements in all assessed outcome measures, indicating that mirror therapy can effectively aid recovery after a stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using mirror therapy in the home environment: a case report. Nilsen, DM., DiRusso, T.[2019]

References

1. Spain pubmed.ncbi.nlm.nih.gov

[Mirror therapy in hemiplegic patient]. [2016]

2. India pubmed.ncbi.nlm.nih.gov

Effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke: A randomized sham-controlled pilot trial. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Effects of mirror therapy on motor and sensory recovery in chronic stroke: a randomized controlled trial. [2016]

4. United States pubmed.ncbi.nlm.nih.gov

Efficacy of mirror therapy on lower limb motor recovery, balance and gait in subacute and chronic stroke: A systematic review. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. [2022]

6. England pubmed.ncbi.nlm.nih.gov

The effects of mirror therapy on the gait of subacute stroke patients: a randomized controlled trial. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

A Mirror Therapy-Based Action Observation Protocol to Improve Motor Learning After Stroke. [2016]

8. United States pubmed.ncbi.nlm.nih.gov

Using mirror therapy in the home environment: a case report. [2019]