Comparative Effects of Mirror Therapy and Cognitive Orientation to Daily Occupational Performance in Stroke: A Randomized Controlled Trial

NCT07546864 | Recruiting

• 1 other identifier: MT_COOP_STROKE_2026_NB
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to compare the effectiveness of three rehabilitation approaches in individuals with stroke: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training. A total of 45 individuals with subacute and chronic stroke will be randomly assigned to one of three groups. Each group will receive 4 weeks of intervention (5 sessions per week), followed by a 3-month follow-up period. Outcomes related to motor function, somatosensory function, activities of daily living, participation, and quality of life will be assessed at baseline, after intervention, and at follow-up. The study aims to determine which intervention approach is more effective in improving functional outcomes in individuals with stroke.

Conditions

Stroke; Stroke Rehabilitaion

Keywords

mirror therapy; Randomized Controlled Trial; Stroke; Cognitive Orientation to Daily Occupational Performance Occupational Therapy; somatosensory; participation; activity daily of life; occupational therapy

Outcome Measures

Primary Outcomes (1)

• Fugl-Meyer Motor Assessment (FMA)

  The Fugl-Meyer Assessment will be used to evaluate motor function in individuals with stroke. Higher scores indicate better motor function.

  Baseline, post-intervention (4 weeks), and 3-month follow-up

Secondary Outcomes (6)

• Revised Nottingham Sensory Assessment (rNSA)

  Baseline, post-intervention (4 weeks), and 3-month follow-up

• Canadian Occupational Performance Measure (COPM)

  Baseline, post-intervention (4 weeks), and 3-month follow-up

• Modified Barthel Index (MBI)

  Baseline, post-intervention (4 weeks), and 3-month follow-up

• Stroke Impact Scale (SIS)

  Baseline, post-intervention (4 weeks), and 3-month follow-up

• Stroke Self-Efficacy Questionnaire (SSEQ)

  Baseline, post-intervention (4 weeks), and 3-month follow-up

Study Arms (3)

Mirror Therapy Group

EXPERIMENTAL

Participants in this group will receive mirror therapy combined with robotic balance training. Mirror therapy will be applied using task-oriented activities involving upper and lower extremities based on individual needs. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied.

Behavioral: Mirror Therapy; Other: Robotic Balance Training

CO-OP Group

EXPERIMENTAL

Participants in this group will receive cognitive orientation to daily occupational performance (CO-OP) combined with robotic balance training. Individualized goals will be determined and cognitive strategies will be used to improve task performance. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied.

Behavioral: Cognitive Orientation to Daily Occupational Performance (CO-OP); Other: Robotic Balance Training

Conventional Occupational Therapy Group

ACTIVE COMPARATOR

Participants in this group will receive conventional occupational therapy combined with robotic balance training. The intervention will include task-oriented activities such as reaching, grasping, coordination, and strengthening exercises. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied.

Behavioral: Conventional Occupational Therapy; Other: Robotic Balance Training

Interventions

Mirror Therapy BEHAVIORAL

Mirror therapy involves the use of a mirror to create a visual illusion of movement of the affected limb by observing the reflection of the unaffected limb. Task-oriented activities are performed to improve motor function and sensory integration in individuals with stroke.

Mirror Therapy Group

Cognitive Orientation to Daily Occupational Performance (CO-OP) BEHAVIORAL

CO-OP is a client-centered, performance-based approach that uses cognitive strategies to enable skill acquisition. Participants identify meaningful goals and use guided discovery and problem-solving strategies to improve task performance.

CO-OP Group

Conventional Occupational Therapy BEHAVIORAL

Conventional occupational therapy includes task-oriented interventions such as reaching, grasping, coordination training, strengthening exercises, and activities aimed at improving functional independence in daily living.

Conventional Occupational Therapy Group

Robotic Balance Training OTHER

Robotic balance training is used as a priming intervention before therapy sessions. It includes repetitive, task-specific movements involving weight shifting, postural control, and balance training to enhance motor responses.

CO-OP Group; Conventional Occupational Therapy Group; Mirror Therapy Group

Eligibility Criteria

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

You may qualify if:

• \- Individuals diagnosed with ischemic or hemorrhagic stroke
• Age 18 years and older
• Subacute (3-6 months post-stroke) or chronic stage (6-12 months post-stroke)
• Brunnstrom Motor Recovery Stage ≥3 for upper extremity, ≥4 for hand, and ≥4 for lower extremity
• Mini-Mental State Examination (MMSE) score ≥24
• No severe visual, orthopedic, or additional neurological impairments
• Not participating in another study during the research period
• Voluntary consent to participate in the study

You may not qualify if:

• \- Poor motor coordination or major medical problems that would prevent participation
• Presence of Wernicke's aphasia
• Botulinum toxin injection within the last 3 months
• Psychiatric conditions that may interfere with participation (e.g., depression, ongoing psychiatric treatment, low motivation)

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Bayburt State Hospital

Bayburt, Merkez, 69000, Turkey (Türkiye)

RECRUITING

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 Officials

• Gokcen Akyurek, Associate Professor

  Hacettepe University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

NURTEN BİLGİN, PhD Student

CONTACT

+905546366542; nurtenncek@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Bu açık etiketli bir çalışmadır. Uygulanan müdahalelerin niteliği nedeniyle herhangi bir körleme yöntemi kullanılmamıştır.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Participants will be randomly assigned to one of three parallel groups: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), or conventional occupational therapy (COT). All groups will receive robotic balance training prior to intervention sessions. Interventions will be applied for 4 weeks, followed by a 3-month follow-up.

Study Record Dates

• First Submitted: April 17, 2026
• First Posted: April 23, 2026
• Study Start: February 15, 2026
• Primary Completion (Estimated): May 15, 2026
• Study Completion (Estimated): June 15, 2027
• Last Updated: April 23, 2026

Record last verified: 2026-04

Locations

TU (1)