Efficacy of Mirror Therapy across Stroke Recovery Phases: A Randomized Trial in Patients with Severe Hemiplegia and Comorbidities

Abstract: Background: Mirror therapy (MT) has been increasingly utilized in post-stroke rehabilitation as a low-cost and non-invasive method to enhance motor recovery. While its efficacy has been established, limited evidence exists on how MT performs when applied at different stages of stroke recovery and among patients with severe motor impairment or medical comorbidities. Objective: This study aimed to evaluate the effectiveness of MT on upper limb motor function, independence, and pain reduction when administered during the acute, subacute, and chronic phases of stroke rehabilitation. It also assessed MT’s impact on patient subgroups with severe hemiplegia and comorbid conditions. Methods: A randomized controlled trial was conducted with 48 post-stroke patients stratified by recovery phase: acute (≤14 days), subacute (2 weeks–3 months), and chronic (>3 months). All participants received 30-minute MT sessions, five times per week, for six weeks. Primary and secondary outcomes were measured using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Barthel Index (BI), and Visual Analog Scale (VAS). Subgroup analyses were performed for patients with severe hemiplegia (FMA-UE <15) and those with comorbidities. Results: The acute group exhibited the highest functional improvement (FMA-UE +14.2, 48.9%; BI +18.1, 30.5%), followed by the subacute (FMA-UE +9.5, 32.6%) and chronic groups (FMA-UE +5.3, 18.4%). Pain reduction was significant in the acute and subacute groups but not in the chronic phase. Patients with severe hemiplegia and comorbidities demonstrated comparable improvements to those without, particularly in early phases. Conclusion: MT is most effective when initiated during the acute stage of stroke rehabilitation, though meaningful gains can also be observed in later phases. Its feasibility, safety, and effectiveness across clinical subgroups support its integration into personalized occupational therapy programs. Further research is needed to refine implementation protocols and assess long-term outcomes. Keywords: mirror therapy, stroke rehabilitation, upper limb recovery, occupational therapy, neuroplasticity, hemiplegia, comorbidity. Title: Efficacy of Mirror Therapy across Stroke Recovery Phases: A Randomized Trial in Patients with Severe Hemiplegia and Comorbidities Author: Myrto Patagia Bakaraki, Zacharis Dimitrios International Journal of Novel Research in Healthcare and Nursing ISSN 2394-7330 Vol. 12, Issue 1, January 2025 - April 2025 Page No: 223-227 Novelty Journals Website: www.noveltyjournals.com Published Date: 30-April-2025 DOI: https://doi.org/10.5281/zenodo.15315171 Paper Download Link (Source) https://www.noveltyjournals.com/upload/paper/Efficacy%20of%20Mirror%20Therapy%20across-30042025-1.pdf