Mirror Therapy and Action Observation Therapy on Upper Limb Sensory Motor Recovery and Quality of Life in Subacute Stroke Patients

NCT07078812 | Completed DMC

• 1 other identifier: UOL/IREB/25/09/0005
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

This clinical study is being conducted to compare the effects of two different rehabilitation techniques-Mirror Therapy and Action Observation Therapy (AOT)-on improving upper limb movement and quality of life in individuals who have recently experienced a stroke. Stroke survivors often face weakness and coordination problems in their arms and hands. Helping them regain motor function is crucial for performing everyday tasks like dressing, eating, and writing. Mirror Therapy works by having patients perform movements while watching the reflection of their unaffected limb in a mirror, tricking the brain into believing both limbs are working. This may help activate brain regions responsible for motor control. Action Observation Therapy, on the other hand, involves patients watching videos of someone else performing arm and hand movements. After observing, patients try to mimic the actions themselves. This method is based on the theory that watching and imitating movements can enhance brain recovery. In this study, patients will be randomly assigned to either the Mirror Therapy group or the Action Observation Therapy group. Both groups will receive therapy over several weeks, along with routine stroke rehabilitation care. Researchers will assess each patient's progress using standard tools to measure arm strength, hand coordination, and overall quality of life. This study aims to find out which therapy leads to better recovery and could become a recommended part of post-stroke rehabilitation programs.

Conditions

Stroke

Keywords

Action observation therapy; Mirror therapy; Quality of life; Stroke rehabilitation; Upper limb recovery

Outcome Measures

Primary Outcomes (1)

• Change in Upper Limb Motor Function as Measured by the Fugl-Meyer Assessment

  The Fugl-Meyer Assessment for Upper Extremity is a standardized, stroke-specific performance-based measure that evaluates motor functioning, balance, and joint coordination. The upper limb subscale (score range: 0-66) assesses voluntary movement, reflex activity, and coordination of the shoulder, elbow, forearm, wrist, and hand. A higher score indicates better motor function and recovery. This tool has strong psychometric properties and is widely used in stroke rehabilitation research to detect motor improvements over time.

  Baseline, Week 3 (Mid-intervention), and Week 6 (Post-intervention)

Secondary Outcomes (2)

• Change in Stroke-Related Disability (Modified Rankin Scale)

  Baseline, Week 3, and Week 6

• Change in Health-Related Quality of Life (Stroke Impact Scale - Version 3.0)

  Baseline, Week 3, and Week 6

Study Arms (2)

Mirror Therapy for Upper Limb Rehabilitation

EXPERIMENTAL

Participants in this arm will undergo Mirror Therapy sessions targeting the affected upper limb. A mirror will be positioned along the patient's midline, reflecting movements of the non-paretic limb, creating the illusion of movement in the affected limb. Patients will perform bilateral symmetrical movements while observing the mirrored reflection for 30 minutes per session, 5 days per week, over a 6-week period. Standard stroke rehabilitation exercises will also be provided.

Behavioral: Mirror Therapy

Action Observation Therapy for Upper Limb Rehabilitation

EXPERIMENTAL

Participants in this arm will receive Action Observation Therapy involving the observation of video clips demonstrating functional upper limb tasks, followed by physical practice of the same movements. Each session will consist of 15 minutes of video observation and 15 minutes of task execution, conducted 5 days per week for 6 weeks. This intervention will be supplemented by routine post-stroke rehabilitation exercises.

Behavioral: Action Observation Therapy

Interventions

Mirror Therapy BEHAVIORAL

Mirror Therapy involves placing a mirror in the patient's midsagittal plane to reflect movements of the unaffected upper limb, creating a visual illusion of movement in the paretic limb. Patients perform bilateral symmetrical movements while focusing on the mirror reflection, helping to stimulate motor cortex activation and promote neuroplasticity. Sessions last 30 minutes, 5 days per week, for 6 weeks. This intervention is delivered in addition to standard stroke rehabilitation.

Mirror Therapy for Upper Limb Rehabilitation

Action Observation Therapy BEHAVIORAL

Action Observation Therapy consists of observing video demonstrations of functional upper limb movements, followed by the patient imitating the observed actions. Each session includes 15 minutes of watching goal-directed tasks and 15 minutes of active execution. This therapy aims to activate the mirror neuron system and enhance motor recovery. The protocol is administered 5 days per week for 6 weeks and is combined with routine stroke rehabilitation practices.

Action Observation Therapy for Upper Limb Rehabilitation

Eligibility Criteria

• Age: 45 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 45 and 65 years (Tsai et al., 2012).
• Gender as either male or female (Tsai et al., 2012).
• Only subacute stroke patients will be included (Uyttenboogaart et al., 2005).
• A baseline Fugl-Meyer Assessment (FMA) score between 20 and 60 for upper limb motor function (Fugl-Meyer et al., 1975).
• The ability to follow study instructions, assessed using the Taiwan version of the Montreal Cognitive Assessment (MoCA) (Tsai et al., 2012), with scores below 26 indicating cognitive impairment, as patients scoring around 60 are considered to have near-normal cognitive function.
• The capability to participate in therapy and assessment sessions (Wang et al., 2011).
• Patient who have 1st onset of stroke ( 1st time stroke) (Hsieh et al., 2009).

You may not qualify if:

• Participants having hamonomus hemianopia (Tsai et al., 2012).
• Other neurological conditions for example, parkinsons, alzehmiers, ADHD, autism, etc (Tsai et al., 2012).
• Participants having recurrent stroke history (Wang et al., 2011).
• Global or receptive aphasia (Banks and Marotta, 2007).
• Severe neglect (Duncan et al., 2003).
• Major medical problems or comorbidities that influenced UE usage or cause severe pain (Hsieh et al., 2009).

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

The University of Lahore Teaching Hospital

Lahore, 54590, Pakistan

Location

MeSH Terms

Conditions

Stroke

Interventions

Mirror Movement Therapy

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Rehabilitation; Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Student

Study Record Dates

• First Submitted: July 12, 2025
• First Posted: July 22, 2025
• Study Start: November 15, 2024
• Primary Completion: May 19, 2025
• Study Completion: July 8, 2025
• Last Updated: July 25, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)