Mirror therapy is a rehabilitation technique used to improve motor function after stroke or for phantom limb pain. During mirror therapy, a mirror is placed so the patient sees the reflection of their unaffected limb moving as if it was the affected one. A review of 14 studies with 567 stroke patients found that mirror therapy improved motor function and activities of daily living compared to other interventions like placebo or no treatment. It also reduced pain and had some evidence to improve neglect. The benefits were stable after 6 months, providing a small spark of hope to ignite thousands of lights for stroke survivors and amputees.

2. Archimedes and the Battle of Syracuse
Using mirrors to burn the Roman’s ships

3. The Reflecting Pool

4. MIRROR THERAPY
Aswathi.p
1st yr Msc Nursing
Al Shifa college of nursing

7. MIRROR THERAPY
Unveiled by Vilayanur S.
Ramachandran & Rogers –1996
Recognize & integrate mismatch
–propioception &visual feed

8. MIRROR THERAPY

9. EQUIPEMENTS
Mirror
box

10. MIRROR THERAPY

11. TECHNIQUE
 places good limb into one
side, & stump in to other,
looks into mirror on the side
with good limb &makes"mirror
symmetric“ movement, as a
symphony conductor might, or
as we do when we clap
our hands.

13. PRINCIPLE

14. MIRROR NEURON
 Frontal & parietal
lobes
Rich in motor
command neurons
Fires to
orchestrate
sequence of muscle
twitches

15. MIRROR THERAPY & STROKE

16. Residue of mirror neurons
Incomplete lesion
STROKE
Cont….

17. Cont…
Visual feed back - Revive motor neurons
Areas are temporarily inactive
Does not reach threshold

18. MIRROR THERAPY &PHANTOM LIMB PAIN

19. Cont…
Learned pain
Vivid presence of limb
Amputation

20. Cont…
Activation of mirror neurons
Mirror visual feed back
Learned immobilization

21. Cont…
Free from phantom limb pain
Start to imitate action performance

22. MIRROR THERAPY & CRPS

23. con
Accidental signals to limb
evokes memories of pain
Attempt to move causes pain
Inflammation

24. Unlearning of learned pain &
learned immobilization
Conveys visual illusion
MIRROR VISUAL FEED BACK

25. OTHER USES
Focal dystonias
Dejerrine Roussy syndrome
Trigeminal neuralgia
Parkinson’ disease

26. REVIEW OF LITERATURE
Mirror therapy for
improving motor
function after stroke

27. Mirror therapy for
improving motor
function after stroke

28. ABSTRACT
 Citation: Thieme H, Mehrholz J, Pohl M,
Behrens J, Dohle C. Mirror therapy for
improving motor function after stroke.

29. Cont…..
Background
Mirror therapy is used to improve
motor function after stroke. During
mirror therapy, a mirror is placed in the
patient’s midsagittal plane, thus
reflecting movements of the non-paretic
side as if it were the affected side

30. Cont…..
Objectives
To summarise effectiveness of
mirror therapy compared with no
treatment, placebo or sham
therapy

31. Cont…..
 To summarise effectiveness
of mirror therapy for improving
motor function, activities of daily
living, pain & visuospatial neglect
in patients after stroke.

32. Cont…..
Methods
Randomised controlled trials
& randomised cross-over trials
comparing mirror therapy
with any control intervention for
patients after stroke.

33. Cont……
Type of participants
Paresis of upper or lower limb, or
both, caused by stroke (all types,
severity & stages of stroke) aged
over 18 yrs.

34. Cont…..
Types of outcome measures
Post-intervention (or change
scores between pre- and post
intervention measures) and at
follow-up after six months or
longer.

35. Cont…..
Primary outcomes
Motor function
Secondary outcomes
Measures of activities of
daily living

36. Cont…..
Data collection and analysis
Two review authors independently
selected trials based on the inclusion
criteria, documented methodological
quality of studies and extracted data.
We analysed the results as
standardised mean differences
(SMDs) for continuous variables.

37. Cont……..
Resuls
Included 14 studies with a total
of 567 participants that compared
mirror therapy with other
interventions.

38. Cont…..
post-intervention data:
SMD 0.61; 95%
confidence interval (CI)
0.22 to 1.0; P = 0.002; change
scores: SMD 1.04; 95% CI 0.57
to 1.51; P < 0.0001

39. Cont…..
However, effects on motor
function are influenced by the
type of control intervention.
Additionally, mirror therapy
may improve activities of daily
living.

40. Cont…..
(SMD 0.33; 95% CI 0.05 to 0.60;
P = 0.02). We found a
significant positive effect on
pain (SMD -1.10; 95% CI –
2.10 to -0.09; P =0.03) which is
influenced by patient
population.

41. Cont…..
We found limited evidence for
improving visuospatial neglect
(SMD 1.22; 95% CI 0.24 to 2.19; P =
0.01). The effects on motor
function were stable at follow-up
assessment after six months.

42. A small spark can ignite
thousands of light

43. Small spark to ignite
thousands of hope
among stroke survivors
& amputees