Evaluating the Effect of Mirror Therapy on Cognitive Neuroplasticity and Motor Recovery in Stroke Rehabilitation

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 Evaluating the Effect of Mirror Therapy on Cognitive Neuroplasticity and Motor Recovery in Stroke Rehabilitation

  Perkash Lal1 , Satish Kumar2, Jeetendar Valecha3, Mahrukh Warraich4, Aneela Shoukat4, Safa Rafaqat4 1Agha Khan University and Hospital, Karachi, Pakistan 2Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan; 3Lincoln University College, Malaysia; 4Iqra University, Islamabad, Pakistan 

 ABSTRACT 

Background: 

Stroke commonly leads to significant motor impairments through cortical damage. Mirror therapy (MT), utilizing visual feedback to stimulate motor cortex activity, has shown promise as a neuroplasticity-enhancing intervention for motor recovery. This study investigated mirror therapy's effects on neuroplastic changes and functional motor outcomes in post-stroke patients during rehabilitation. 

 Methodology: 

We conducted a randomized controlled trial with 40 post-stroke patients (ages 40–70) presenting upper limb motor deficits. Participants were randomly allocated to mirror therapy (Group A) or task-oriented training (Group B). Both groups received 6-week interventions, 5 sessions weekly. Cognitive neuroplasticity was measured using Trail Making Tests (TMT) assessing attention, visual search, and executive function. Motor function evaluation included Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT). 

 Results: 

All 40 patients (mean age 58.7±7.9 years) completed the intervention. While both groups demonstrated significant within group improvements (p<0.001), mirror therapy showed superior effectiveness over task-oriented training. TMT improvements significantly favored mirror therapy: TMT-A (-26.3±8.9 vs -14.4±7.2 seconds, p<0.001); TMT-B (-43.8±12.7 vs -19.5±9.8 seconds, p<0.001). Motor assessments similarly favored mirror therapy: FMA-UE (+15.8±4.3 vs +10.7±3.9 points, p<0.001); ARAT (+13.8±3.7 vs +8.8±4.1 points, p<0.001). Effect sizes were large across measures (Cohen's d: 1.25-2.12). 

 Conclusion: 

Mirror therapy demonstrated clear superiority over task-oriented training for enhancing cognitive neuroplasticity and motor recovery in stroke patients. These results suggest mirror therapy provides comprehensive benefits addressing multiple post stroke impairment aspects simultaneously, supporting its integration into standard rehabilitation protocols for upper limb motor deficits. Keywords: Cognitive Neuroplasticity, Mirror Therapy, Motor Recovery, Stroke Rehabilitation, Upper Limb Function.