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Effects of Mirror Therapy and Motor Imagery on Upper Limb Motor Functions in Middle Cerebral Artery Stroke
Sponsor: Lahore University of Biological and Applied Sciences
Summary
This study will compare mirror therapy (MT) with motor imagery (MI), each added to routine Bobath-based physical therapy, to assess upper limb motor function and functional independence in patients with subacute middle cerebral artery (MCA) stroke. Upper limb dysfunction is a common and disabling consequence of MCA stroke, affecting reaching, grasping, manipulation and daily activities. Although MT and MI have each shown benefit, it is unclear which adjunct gives greater and longer-lasting improvement. A total of 36 adults aged 45-60 years will be randomly allocated 1:1 into an MT group or an MI group. Both groups will receive 3 supervised sessions per week for 6 weeks, followed by a 6-week home exercise program. Outcomes (Fugl-Meyer Assessment-Upper Extremity, Action Research Arm Test, Box and Block Test, Modified Barthel Index) will be assessed at baseline, post-intervention (Week 6) and follow-up (Week 12). The study aims to determine which intervention gives superior improvement in upper limb recovery.
Key Details
Gender
All
Age Range
45 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
36
Start Date
2026-08-15
Completion Date
2027-01-30
Last Updated
2026-10-28
Healthy Volunteers
No
Conditions
Interventions
Mirror Therapy
Participants sit with a mirror placed in the midsagittal plane, the affected limb hidden behind it and the unaffected limb reflected to create the illusion of normal movement. Therapist-guided training for 20 minutes per session (10 repetitions per task × 2 sets) progresses from simple shoulder, elbow, forearm and hand movements (Weeks 1-2), to reaching, grasp and release, and object manipulation (Weeks 3-4), to functional reaching, fine hand tasks, and speed and accuracy training (Weeks 5-6). It is combined with 30 minutes of routine Bobath-based physical therapy.
Motor Imagery
Participants sit with eyes closed and mentally rehearse movements of the affected upper limb without physically performing them, using visual and kinesthetic imagery with standardized verbal cues. Sessions last 20 minutes (10 imagery trials per task × 2 sets) and progress from relaxation and imagery of simple movements (Weeks 1-2), to imagined reaching, grasp and release, and object manipulation (Weeks 3-4), to functional reaching, fine hand activities, ADL rehearsal and error correction (Weeks 5-6). It is combined with 30 minutes of routine Bobath-based physical therapy.
Routine Physical Therapy
Routine physical therapy based on the Bobath concept, given to all participants for 30 minutes per session, 3 times per week for 6 weeks. It focuses on normalizing tone, facilitating normal movement patterns, weight shifting, postural control and functional upper limb activities while inhibiting abnormal movement patterns. Weeks 1-2: scapular mobilization, weight-bearing, trunk control, assisted ROM, sensory stimulation. Weeks 3-4: active-assisted reaching, elbow extension, wrist and hand opening, grasp and release. Weeks 5-6: task-oriented reaching, functional grasp, object manipulation, ADL-based practice. After 6 weeks, all participants follow a 6-week home exercise program. Routine physical therapy based on the Bobath concept, given to all participants for 30 minutes per session, 3 times per week for 6 weeks. It focuses on normalizing tone, facilitating normal movement patterns, weight shifting, postural control and functional upper limb activities while inhibiting abnormal movemen
Locations (1)
Alfalah Medical Center
Lahore, Punjab Province, Pakistan