Comparative Effects of Mirror Therapy and Standard Physiotherapy in Complex Regional Pain Syndrome

NCT07332884 | Completed DMC

• 1 other identifier: 70146229@student.uol.edu.pk
• Study Type: interventional
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition characterized by persistent pain, sensory disturbances, motor dysfunction, and functional impairment, often following trauma or surgery. Conventional physical therapy is commonly used in the management of CRPS; however, treatment outcomes are often variable and incomplete. Mirror therapy is a non-invasive rehabilitation technique that uses visual feedback to influence cortical reorganization and may help reduce pain and improve motor function in patients with CRPS. The purpose of this study is to compare the effectiveness of mirror therapy with routine physical therapy in patients diagnosed with Complex Regional Pain Syndrome. Eligible participants will be allocated into two groups. One group will receive mirror therapy in addition to standard rehabilitation exercises, while the control group will receive routine physical therapy alone. Both interventions will be delivered over a defined treatment period under supervised conditions. Primary outcomes will include changes in pain intensity, while secondary outcomes will assess functional ability, range of motion, and overall limb use. Outcomes will be measured at baseline and after completion of the intervention period. This study aims to determine whether mirror therapy provides additional benefits over routine physical therapy in reducing pain and improving functional outcomes in patients with Complex Regional Pain Syndrome.

Conditions

Complex Regional Pain Syndrome

Keywords

Complex Regional Pain Syndrome CRPS; Motor Function; Mirror therapy; Neuro rehabilitation; Pain management

Outcome Measures

Primary Outcomes (3)

• Pain management

  Participants in both arms will receive interventions aimed at reducing pain associated with Complex Regional Pain Syndrome. For the Mirror Therapy Group, pain reduction is targeted through visual-motor feedback, which can help retrain the brain and reduce pain perception. For the Routine Physical Therapy Group, pain is managed through exercises, stretching, and functional activities that improve mobility, reduce stiffness, and decrease pain intensity.

  Duration of intervention: 4 weeks Frequency: 30 minutes per session, 5 sessions per week Pain assessments will be conducted at baseline (pre-intervention), weekly during the intervention, and at the end of 4 weeks to evaluate changes in pain intensity

• Hand Grip

  Hand grip strength will be measured using a dynamometer to assess the functional strength of the affected limb in patients with Complex Regional Pain Syndrome. Participants will be instructed to squeeze the dynamometer maximally for a few seconds, and the best of three trials will be recorded for accuracy. This measurement evaluates improvements in motor function and muscle strength as a result of the intervention.

  • Baseline assessment: Before the start of the intervention • Interim assessments: Weekly during the 4-week intervention period • Final assessment: At the end of 4 weeks

• spasticity

  Spasticity of the affected limb will be assessed using the Modified Ashworth Scale (MAS), which grades muscle tone from 0 (no increase in tone) to 4 (rigid in flexion or extension). The assessment evaluates resistance to passive movement, helping to determine changes in muscle stiffness and motor control resulting from the intervention.

  Baseline: Before the start of the intervention • Interim assessments: Weekly during the 4-week intervention period • Final assessment: At the end of 4 weeks

Study Arms (2)

Mirror Therapy Group

EXPERIMENTAL

Participants in this arm will receive mirror therapy, a rehabilitation technique where movements of the unaffected limb are reflected in a mirror to create a visual illusion that the affected limb is moving normally. Therapy sessions will be conducted \[specify frequency, e.g., 30 minutes per day, 5 days a week\] for \[specify duration, e.g., 4 weeks\].

Other: Mirror Therapy

Routine Physical Therapy Group

EXPERIMENTAL

Participants in this arm will receive standard physical therapy for CRPS, including exercises, stretching, and functional activities aimed at improving mobility, reducing pain, and enhancing limb function. Sessions will be conducted \[specify frequency, e.g., 30 minutes per day, 5 days a week\] for \[specify duration, e.g., 4 weeks\].

Other: Routine Physical Therapy

Interventions

Mirror Therapy OTHER

Participants perform movements with the unaffected limb while watching its reflection in a mirror, creating the visual illusion that the affected limb is moving normally. Aimed at reducing pain and improving motor functio

Mirror Therapy Group

Routine Physical Therapy OTHER

Standard physical therapy including stretching, strengthening, and functional exercises to improve mobility, reduce pain, and restore limb function in CRPS patients.

Routine Physical Therapy Group

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 40-65 years
• Both genders
• Hemiplegic patients with subacute stage
• Patients who developed CRPS of the hand due to stroke
• Patients with a diagnosis of CRPS 1

You may not qualify if:

• Comorbid conditions (e.g., decompensated heart failure, chronic renal insufficiency
• Hand arthritis
• Arterial/venous injuries and/ or undergoing arterial revascularization

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

University of Lahore teaching hospital

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (10)

• Ozdemir EC, Elhan AH, Kucukdeveci AA. Effects of mirror therapy in post-traumatic complex regional pain syndrome type-1: a randomized controlled study. J Rehabil Med. 2024 Sep 24;56:jrm40417. doi: 10.2340/jrm.v56.40417.

  PMID: 39318174 RESULT

• Kotiuk V, Burianov O, Kostrub O, Khimion L, Zasadnyuk I. The impact of mirror therapy on body schema perception in patients with complex regional pain syndrome after distal radius fractures. Br J Pain. 2019 Feb;13(1):35-42. doi: 10.1177/2049463718782544. Epub 2018 Jun 13.

  PMID: 30671237 RESULT

• Khoramdel F, Ravanbod R, Akbari H. Effect of high-intensity laser therapy and mirror therapy on complex regional pain syndrome type I in the hand area: A randomized controlled trial. J Hand Ther. 2025 Oct-Dec;38(4):791-798. doi: 10.1016/j.jht.2025.02.009. Epub 2025 Mar 21.

  PMID: 40118675 RESULT

• Harmsen, W. J., Bulten, R., & Schrier, E. (2020). The effectiveness of mirror therapy and graded motor imagery for complex regional pain syndrome: A randomized controlled trial. European Journal of Pain, 24(8), 1575-1587.

  RESULT

• Giostri GS, Souza CDA. Complex Regional Pain Syndrome. Rev Bras Ortop (Sao Paulo). 2024 Apr 22;59(4):e497-e503. doi: 10.1055/s-0044-1779331. eCollection 2024 Aug.

  PMID: 39239587 RESULT

• Ferraro MC, Cashin AG, Wand BM, Smart KM, Berryman C, Marston L, Moseley GL, McAuley JH, O'Connell NE. Interventions for treating pain and disability in adults with complex regional pain syndrome- an overview of systematic reviews. Cochrane Database Syst Rev. 2023 Jun 12;6(6):CD009416. doi: 10.1002/14651858.CD009416.pub3.

  PMID: 37306570 RESULT

• Donati D, Boccolari P, Giorgi F, Berti L, Platano D, Tedeschi R. Breaking the Cycle of Pain: The Role of Graded Motor Imagery and Mirror Therapy in Complex Regional Pain Syndrome. Biomedicines. 2024 Sep 20;12(9):2140. doi: 10.3390/biomedicines12092140.

  PMID: 39335652 RESULT

• Cuenca-Martinez F, Reina-Varona A, Castillo-Garcia J, La Touche R, Angulo-Diaz-Parreno S, Suso-Marti L. Pain relief by movement representation strategies: An umbrella and mapping review with meta-meta-analysis of motor imagery, action observation and mirror therapy. Eur J Pain. 2022 Feb;26(2):284-309. doi: 10.1002/ejp.1870. Epub 2021 Oct 8.

  PMID: 34592050 RESULT

• Cacchio A, De Blasis E, De Blasis V, Santilli V, Spacca G. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients. Neurorehabil Neural Repair. 2009 Oct;23(8):792-9. doi: 10.1177/1545968309335977. Epub 2009 May 22.

  PMID: 19465507 RESULT

• Buraschi, R., Ranica, G., Nicassio, F., Falso, M. V., & Pollet, J. (2024). Efficacy of rehabilitative intervention on pain and function in patients with upper limb complex regional pain syndrome: A systematic review. Topics in Geriatric Rehabilitation, 40(2), 139-146.

  RESULT

MeSH Terms

Conditions

Complex Regional Pain Syndromes; Agnosia

Interventions

Mirror Movement Therapy

Condition Hierarchy (Ancestors)

Autonomic Nervous System Diseases; Nervous System Diseases; Peripheral Nervous System Diseases; Neuromuscular Diseases; Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Rehabilitation; Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Masking in a clinical trial refers to the process of concealing certain information from participants, investigators, or other involved parties to prevent bias in the study's outcomes. In addition to the primary parties listed (such as participants, investigators, or outcome assessors), other parties who may be masked can include data analysts, laboratory personnel, or pharmacists responsible for preparing interventions. This ensures that those involved in handling, analyzing, or interpreting study data remain unaware of group assignments, maintaining the integrity and objectivity of the trial results.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This is a parallel-group interventional study in which eligible participants with Complex Regional Pain Syndrome are allocated into two intervention arms. One group receives mirror therapy in addition to routine physical therapy, while the comparison group receives routine physical therapy alone. Participants remain in their assigned intervention group for the duration of the study, and outcomes are assessed at baseline and after completion of the intervention period.

Study Record Dates

• First Submitted: December 30, 2025
• First Posted: January 12, 2026
• Study Start: November 24, 2024
• Primary Completion: May 4, 2025
• Study Completion: October 10, 2025
• Last Updated: January 12, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)