Effects of a Mirror-Induced Visual Illusion on a Reaching Task in Stroke Patients Implications for Mirror Therapy Training

Mirror training has been considered useful since at least 1999.
Rehabilitation of hemiparesis after stroke with a mirror
Altschuler EL, Wisdom SB, Stone L, Foster C, Galasko D, Llewellyn DME, Ramachandran V
The Lancet - Vol. 353, Issue 9169, 12 June 1999, Pages 2035-2036
15 f*cking years later and we still do not have a protocol. Does anyone in stroke do ANYTHING AT ALL?
 Who will create a defined protocol for it? Obviously not the ASA, NSA or WSO. So YOU are going to have to tackle the dangerous task  of creating your own protocol of how to look at your affected side in the mirror. Be careful of breaking that mirror.
http://nnr.sagepub.com/content/28/7/652?etoc

1. Ruud W. Selles, PhD1
2. Marian E. Michielsen, PhD1,†
3. Johannes B. J. Bussmann, PhD1
4. Henk J. Stam, MD, PhD1
5. Henri L. Hurkmans, PhD1
6. Iris Heijnen, MSc2
7. Danielle de Groot, MSc3
8. Gerard M. Ribbers, MD, PhD1,4

1. ¹Erasmus MC- University Medical Center, Rotterdam, Netherlands
2. ²Rehabilitation Centre Blixembosch, Libra Zorggroep, Eindhoven, Netherlands
3. ³Rehabilitation Centre Leijpark, Libra Zorggroep, Tilburg, Netherlands
4. ⁴Rijndam Rehabilitation Centre, Rotterdam, Netherlands
5. ^†Deceased

1. Ruud W. Selles, Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC- University Medical Center, Room h.018, PO Box 2040, 3000 CE, Rotterdam, Netherlands. Email: r.selles@erasmusmc.nl

Abstract

Background. Although most mirror therapy studies have shown improved motor performance in stroke patients, the optimal mirror training protocol still remains unclear. Objective. To study the relative contribution of a mirror in training a reaching task and of unilateral and bimanual training with a mirror. Methods. A total of 93 stroke patients at least 6 months poststroke were instructed to perform a reaching task as fast and as fluently as possible. They performed 70 practice trials after being randomly allocated to 1 of 5 experimental groups: training with (1) the paretic arm with direct view (Paretic-No Mirror), (2) the nonparetic arm with direct view (Nonparetic-No Mirror), (3) the nonparetic arm with mirror reflection (Nonparetic Mirror), (4) both sides and with a nontransparent screen preventing visual control of paretic side (Bilateral-Screen), and (5) both sides with mirror reflection of the nonparetic arm (Bilateral-Mirror). As baseline and follow-up, patients performed 6 trials using only their paretic side. Primary outcome measure was the movement time. Results. We found the largest intervention effect in the Paretic-No Mirror condition. However, the Nonparetic-Mirror condition was not significantly different from the Paretic-No Mirror condition, while the Unaffected-No Mirror condition had significantly less improvement than the Paretic-No Mirror condition. In addition, movement time improved significantly less in the bimanual conditions and there was no difference between both bimanual conditions or between both mirror conditions. Conclusion. The present study confirms that using a mirror reflection can facilitate motor learning. In this task, bimanual movement using mirror training was less effective than unilateral training.