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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores different ways to help stroke patients regain movement in a paralyzed or weakened hand. It compares traditional mirror therapy, where a mirror tricks the brain into thinking the affected hand is moving, with a new device called Miraπ, which physically moves the hand. The goal is to determine which method more effectively improves hand function. This trial suits stroke survivors who have difficulty moving one hand and are currently in a rehab program. As an unphased trial, it provides stroke survivors the opportunity to explore innovative rehabilitation methods that could enhance their recovery journey.

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 prior data suggests that the Miraπ device is safe for stroke rehabilitation?

Research has shown that mirror therapy is generally safe for people. This therapy uses a mirror to create a visual illusion that aids in recovery. The Miraπ device enhances this therapy with a robotic feature and prioritizes safety. Studies have found that the device employs controls to ensure safe use for both patients and therapists. This stability is crucial for preventing harm.

Overall, both traditional mirror therapy and the Miraπ device are well-tolerated by patients, with no major side effects reported in the reviewed studies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Mirror Therapy for stroke rehabilitation because it offers a non-invasive way to engage the brain's ability to reorganize and adapt after injury. Unlike conventional therapies that focus on physical exercises, Mirror Therapy uses visual feedback to trick the brain into perceiving movement in the affected arm, which can accelerate recovery. The experimental Miraπ device takes this a step further by potentially enhancing the therapy's effectiveness, offering a fresh approach to improving motor skills and reducing recovery time. This innovative method could lead to faster, more efficient rehabilitation for stroke survivors.

What evidence suggests that this trial's treatments could be effective for stroke rehabilitation?

Research shows that mirror therapy can help stroke survivors improve movement. In this trial, participants will be divided into two groups. One group will receive conventional mirror therapy, which studies have shown can reduce the time it takes stroke survivors to move by 18.3%, allowing them to move faster. Another review found that mirror therapy can be especially effective when done over a longer period. The other group will use the Miraπ device, designed to physically move the affected limb, potentially enhancing treatment effectiveness. Both regular mirror therapy and the Miraπ device have shown improvements, but the Miraπ device might offer even better results due to its unique method. ^{6 7 8 9 10}

Who Is on the Research Team?

Necolle Morgado-Vega

Principal Investigator

Yale University

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

Citations

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withpower.com/trial/phase-stroke-2-2025-00f6c

Mirror Therapy for Stroke Rehabilitation (MiraPi Trial)

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 ...

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This review aims to investigate the evidence for effectiveness and cost-effectiveness of mirror therapy in people after stroke.

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Effectiveness of mirror therapy in upper limb rehabilitation ...

The studies conducted so far have yielded interesting results, however only a few works have been performed with a significant number of participants and with ...

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mdpi.com/2077-0383/13/24/7808

The Role of Mirror Therapy in the Rehabilitation ...

Although both groups demonstrated improvement in all outcome measures after 1 month of treatment, the improvement was significantly greater in patients who ...

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A Systematic Review and Meta-Analysis of Its Efficacy in ...

Conclusions: imVR demonstrates potential for improving upper limb motor function following stroke, particularly with longer intervention durations and ...

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This study evaluates the effects of mirror therapy on upper-limb motor impairment in stroke patients early after their cerebrovascular accident.

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The data collected weremainly divided on the basis of application in stroke rehabilitation, modes of intervention delivery, and types of control ...

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Mirror Therapy Device for Stroke · Info for Participants

Mirror therapy is generally considered safe for humans, as it involves using a mirror to create a visual illusion that can help with rehabilitation, ...

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sciencedirect.com

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Robotic mirror therapy for stroke rehabilitation through ...

The system's global stability is proven using passivity analysis to ensure safe operation for the patient and therapist. Furthermore, the controllers do not ...