Neurodevelopmental Technique Versus Mirror Therapy in Sub-acute Stroke Patients

NCT07742020 | Recruiting

• 1 other identifier: REC-UOL-/507/08/24
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

As neurodevelopmental technique and mirror therapy had different effects on lower limb coordination, functions and ambulation. Both had proven to be helpful in the stroke patients to gain functional independency. Therefore, there was need to find out the best treatment approach either NDT, mirror therapy or both are equally effective to improve motor functions, coordination and ambulation of lower limb. This study would provide the health professionals the evidence to use best technique among these according to improvement in patients' coordination, function and ambulation.The study will be randomized clinical trial. This study will be conducted at the University of Lahore. A sample size of 40 will be randomly allocated by into two experimentals groups, (20 participants in each group), by the lottery method. All the screened and willing participants will be randomly allocated to two groups (Group A: Experimental group Neurodevelopmental technique, Group B: Experimental Group mirror therapy exercise) by lottery method. This study will be a single blinded study in which assessor will be blinded.

Conditions

Hemiplegia; Subacute Stroke; Stroke Rehabilitation

Keywords

Neurodevelopmental Technique (NDT); Mirror Therapy (MT); stroke; subacute stroke; hemiplegia; motor function; balance; coordination; ambulation; rehabilitation

Outcome Measures

Primary Outcomes (3)

• Ambulation

  Ambulation will be assessed using the Six-Minute Walk Test (6MWT), which measures the distance a participant walks on a flat surface in six minutes. Unit of Measure:- Meters

  Baseline and Week 12

• Lower Extremity Motor Function

  Lower extremity motor function will be assessed using the Fugl-Meyer Assessment-Lower Extremity (FMA-LE). Unit of Measure:- Total score (0-34)

  Baseline and Week 12

• Lower Limb Coordination

  Lower limb coordination will be assessed using the Lower Extremity Motor Coordination Test (LEMOCOT). Unit of Measure:- Number of target touches completed in 20 seconds

  Baseline and Week 12

Study Arms (2)

Experimental: Neurodevelopmental Technique + Routine PT

EXPERIMENTAL

Participants will receive Neurodevelopmental Technique (NDT) in supine, prone, sitting, and standing positions. Exercises include bridging, trunk rotation, hip/knee/ankle mobilization, bilateral weight bearing, stepping, and toe rise. Each exercise repeated 20 times per set with 2-minute rest between sets. Session duration: 65 minutes, three times per week, for 12 weeks (36 sessions total), in addition to routine physiotherapy.

Behavioral: Neurodevelopmental Technique (NDT)

Active Comparator: Mirror Therapy + Routine PT

ACTIVE COMPARATOR

Participants will receive Mirror Therapy using a mirror (60×90 cm) placed midsagittal to reflect the unaffected leg. Bilateral symmetrical lower limb movements include heel raises, side stepping, single leg standing, hip/knee flexion-extension with ankle dorsiflexion, and ankle eversion. Each exercise repeated 20 times per set with 2-minute rest between sets. Session duration: 60-65 minutes, three times per week, for 12 weeks (36 sessions total), in addition to routine physiotherapy.

Behavioral: Mirror Therapy (MT)

Interventions

Neurodevelopmental Technique (NDT) BEHAVIORAL

Participants will perform Neurodevelopmental Technique (NDT) exercises in supine, prone, sitting, and standing positions. Activities include bridging, trunk rotation, hip/knee flexion-extension, ankle mobilization, bilateral weight bearing, stepping, toe rise, and single leg standing. Each exercise is performed 20 times per set with 2-minute rest intervals. Sessions last 65 minutes, three times per week, for 12 weeks (36 sessions), combined with routine physiotherapy.

Experimental: Neurodevelopmental Technique + Routine PT

Mirror Therapy (MT) BEHAVIORAL

Patient sits with mirror (60×90 cm) reflecting unaffected leg. Performs bilateral symmetrical movements: heel raises, side stepping, single leg standing, hip/knee flexion-extension with ankle dorsiflexion, ankle eversion. Each exercise 20× per set, 2 min rest between sets. 60-65 min/session, 3×/week, for 12 weeks (36 sessions).

Active Comparator: Mirror Therapy + Routine PT

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 range between 45 to 65 years
• Both genders
• Sub-acute stroke hemiplegic cases; clinically stable, fully oriented and conscious.
• Both ischemic and hemorrhagic patients were be included.
• Patients with mini mental status examination (MMSE) (score \> 23)

You may not qualify if:

• Patients had recurrent stroke.
• Any systemic conditions that limit functions such as; cardiac diseases (exertional dyspnea, angina, Myocardial Infarction, Pacemaker) Pulmonary diseases (Asthma, Pulmonary Fibrosis etc.), Diabatic neuropathy, Diabetic foot, Varicose veins etc
• Other neurological conditions, such as; foot drop, muscular dystrophy, Myasthenia Gravis, Parkinsonism
• Any visual and hearing problem
• Any surgical and traumatic history of fractures, dislocations and/or brain injury due to any traumatic events.

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

University of Lahore teaching hospital

Lahore, Punjab Province, 55150, Pakistan

RECRUITING

MeSH Terms

Conditions

Hemiplegia; Stroke

Interventions

Mirror Movement Therapy

Condition Hierarchy (Ancestors)

Paralysis; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Rehabilitation; Therapeutics

Study Officials

• Iqra Abdul Jabbar, MSPTN

  Faculty of Allied Health Sciences, University Institute of Physical Therapy, University of Lahore

  PRINCIPAL INVESTIGATOR

• Hafiza Sana Ashraf, MSPT MSK

  Faculty of Allied Health Sciences, University Institute of Physical Therapy, University of Lahore

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ishaq Ahmed, PHD Ishaq Ahmed, PHD, PHD

CONTACT

Telephone: 0334 4066 463; ishaq.ahmed@uipt.uol.edu.pk

Ashfaq Ahmed

CONTACT

Telephone: 03009449192; ashfaq.ahmad@uipt.uol.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Single (Outcomes Assessor) Study will be single and assessor blinded. Participants will be masked about other groups but they will know what treatment they will be receiving or what exercises they will be doing. Principal investigator would also not be masked or blinded because investigator would be applying the techniques on participants of both group. So participant and and principal investigator cannot be blinded. Only assessor will be blinded and he will take outcome measures without knowing the problem and treatment techniques.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 11, 2025
• First Posted: August 3, 2026
• Study Start: September 8, 2025
• Primary Completion: July 30, 2026
• Study Completion (Estimated): August 15, 2026
• Last Updated: August 3, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)