Mirror Therapy – Lower Extremity

One fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Mohan et al., 2013) investigated the effect of lower extremity mirror therapy on balance in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups also received conventional strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. rehabilitation. Balance was measured by the Brunnel Balance Assessment at post-treatment (2 weeks). No significant between-group difference was found.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCT that lower extremity mirror therapy is not more effective than a comparison therapy (sham mirror therapy) for improving balance in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Mohan et al., 2013) investigated the effect of lower extremity mirror therapy on mobility in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups also received conventional strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. rehabilitation. Mobility was measured by the Functional AmbulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
Categories at post-treatment (2 weeks). A significant between-group difference was found, in favour of mirror therapy vs. sham therapy.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison therapy (sham mirror therapy) for improving mobility in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Mohan et al., 2013) investigated the effect of lower extremity mirror therapy on motor function in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups also received conventional strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. rehabilitation. Lower extremity motor function was measured by the Fugl-Meyer Assessment (Lower Extremity score) at post-treatment (2 weeks). No significant between-group difference was found.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison therapy (sham therapy) for improving lower extremity motor function in patients with acute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Sutbeyaz et al., 2007) investigated the effect of lower extremity mirror therapy on functional ambulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Functional ambulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
was measured by the Functional AmbulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
Categories at post-treatment (4 weeks) and follow-up (6 months). No significant between-group difference was found at follow-up.
Note: Post-treatment results were not reported.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison intervention (sham mirror therapy) for improving functional ambulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCTs (Sutbeyaz et al., 2007) investigated the effect of lower extremity mirror therapy on functional independence in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Functional independence was measured by the Functional Independence Measure (Motor score) at post-treatment (4 weeks) and follow-up (6 months). A significant difference was seen at follow-up, in favour of mirror therapy vs. sham mirror therapy.
Note: Post-treatment results were not reported.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving functional independence in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Ji & Kim, 2014) investigated the effect of lower extremity mirror therapy on gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCT randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Temporospatial gait characteristics (single stance, step length, stance phase, swing phase, velocity, cadence, stride length, step width) were measured by a motion analysis device at post-treatment (4 weeks). Significant between-group differences were found in 3 measures (single stance, step length, stride length), in favour of mirror therapy vs. sham mirror therapy.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving some gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
measures in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Xu et al., 2017) investigated the effect of lower extremity mirror therapy on mobility in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with foot drop to receive lower extremity mirror therapy, mirror therapy and neuromuscular electrical stimulation (NMES), or sham mirror therapy. Mobility was measured by the 10 meter Walk Test at post-treatment (4 weeks). Significant between-group difference was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.

Note: Significant between-group differences were also found in favour of mirror therapy + NMES vs. lower extremity mirror therapy and vs. sham mirror therapy.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving mobility in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Two high quality RCTs (Sutbeyaz et al., 2007; Xu et al., 2017) investigated the effect of lower extremity mirror therapy on lower extremity motor recovery in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCT (Sutbeyaz et al., 2007) randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Lower extremity motor recovery was measured by Brunnstrom stages of motor recovery (Lower extremity score) at post-treatment (4 weeks) and follow-up (6 months). A significant between-group difference was found at follow-up, in favour of mirror therapy vs. sham mirror therapy.

Note: post-treatment results were not reported.

The second high quality RCT (Xu et al., 2017) randomized patients with foot drop to receive lower extremity mirror therapy, mirror therapy and neuromuscular electrical stimulation (NMES), or sham mirror therapy. Lower extremity motor recovery was measured by Brunnstrom stages of motor recovery (Lower extremity score) at post-treatment (4 weeks). A significant between-group difference was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.

Note: A significant between-group difference was found in favour of mirror therapy + NMES vs. sham mirror therapy. There were no significant differences between lower extremity mirror therapy vs. mirror therapy + NMES.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving lower extremity motor recovery in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Xu et al., 2017) investigated the effect of lower extremity mirror therapy on range of motion in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. . This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with foot drop to receive lower extremity mirror therapy, mirror therapy and neuromuscular electrical stimulation (NMES), or sham mirror therapy. Passive range of motion on ankle dorsiflexionTurning an appendage in an upward direction, for example turning the foot so that the angle between the foot and the leg decreases.
was measured by a goniometer at post-treatment (4 weeks). A significant between-group difference was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.

Note: A significant between-group difference was found in favour of mirror therapy + NMES vs. sham mirror therapy. There were no significant differences between lower extremity mirror therapy vs. mirror therapy + NMES.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving range of motion (ankle dorsiflexionTurning an appendage in an upward direction, for example turning the foot so that the angle between the foot and the leg decreases.
) in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Two high quality RCTs (Sutbeyaz et al., 2007; Xu et al., 2017) investigated the effect of lower extremity mirror therapy lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

The first high quality RCT (Sutbeyaz et al., 2007) randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
was measured by the Modified Ashworth Scale at post-treatment (4 weeks) and follow-up (6 months). No significant between-group difference was found at follow-up.
Note: Post-treatment results were not reported.

The second high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Xu et al., 2017) randomized patients with foot drop to receive lower extremity mirror therapy, mirror therapy and neuromuscular electrical stimulation (NMES), or sham mirror therapy. Lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
was measured by the Modified Ashworth Scale (plantar flexion) at post-treatment (4 weeks). No significant between-group difference was found when comparing lower extremity mirror therapy vs. sham mirror therapy.
Note: Significant between-group difference was found in favour of mirror therapy + NMES vs. sham mirror therapy. There were no significant differences between lower extremity mirror therapy vs. mirror therapy + NMES.

Conclusion: There is strong evidence (Level 1a) from two high quality RCTs that mirror therapy is not more effective than a comparison intervention (sham mirror therapy) for reducing lower extremity spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
in patients with subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Arya, Pandian & Kumar, 2017) investigated the effect of lower extremity mirror therapy on gait in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or time-matched conventional rehabilitation. Gait was measured by the Rivermead visual gait assessment at post-treatment (3 months). A significant between-group difference was found, in favour of mirror therapy vs. conventional rehabilitation.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (conventional rehabilitation) for improving gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Arya, Pandian & Kumar, 2017) investigated the effect of lower extremity mirror therapy on lower extremity motor function in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or time-matched conventional rehabilitation. Lower extremity motor function was measured by the Fugl-Meyer Assessment (Lower extremity score) at post-treatment (3 months). A significant between-group difference was found, in favour of mirror therapy vs. conventional rehabilitation.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (conventional rehabilitation) for improving lower extremity motor function in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Arya, Pandian & Kumar, 2017) and one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Abo Salem & Huang, 2015) investigated the effect of lower extremity mirror therapy on motor recovery in patients with chronic stroke.

The high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Arya, Pandian & Kumar, 2017) randomized patients to receive lower extremity mirror therapy or time-matched conventional rehabilitation. Lower extremity motor recovery was measured by the Brunnstrom stages of motor recovery (Lower extremity score) at post-treatment (3 months). No significant between-group difference was found.

The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Abo Salem & Huang, 2015) randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Lower extremity motor recovery was measured by the Brunnstrom stages of motor recovery (Lower extremity score) at post-treatment (4 weeks). A significant between-group difference was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison intervention (conventional rehabilitation) for improving motor recovery in the chronic phase of strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. recovery.

Note: However, a fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that lower extremity mirror therapy was more effective than sham mirror therapy for improving motor recovery. The studies differed in the intensity and duration of intervention, as well as the type of mirror therapy and comparison intervention provided.

One fair quality RCT (Abo Salem & Huang, 2015) investigated the effect of lower extremity mirror therapy on range of motion in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Passive range of motion on ankle dorsiflexionTurning an appendage in an upward direction, for example turning the foot so that the angle between the foot and the leg decreases.
was measured by a goniometer at post-treatment (4 weeks). A significant between-group difference was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving range of motion (ankle dorsiflexionTurning an appendage in an upward direction, for example turning the foot so that the angle between the foot and the leg decreases.
) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Abo Salem & Huang, 2015) investigated the effect of lower extremity mirror therapy on spasticity in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. SpasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
(ankle plantarflexion) was measured by the Modified Ashworth Scale at post-treatment (4 weeks). No significant between-group difference was found.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison intervention (sham mirror therapy) for reducing spasticityInvoluntary muscle tightness and stiffness that can occur after a stroke. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. Spasticity can increase initially but wane down later on, after stroke.
(ankle plantarflexion) in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One high quality RCT (Arya, Pandian & Kumar, 2017) and one fair quality RCT (Abo Salem & Huang, 2015) investigated the effect of lower extremity mirror therapy on walking speed in patients with chronic stroke.

The high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Arya, Pandian & Kumar, 2017) randomized patients to receive mirror therapy or time-matched conventional rehabilitation. Walking speed was measured by the 10 Meter Walk Test (10MWT -Comfortable speed, Maximum speed) at post-treatment (3 months). No significant between-group differences were found.

The fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. (Abo Salem & Huang, 2015) randomized patients to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Walking speed was measured by the 10MWT at post-treatment (4 weeks). A significant between-group difference was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison intervention (conventional rehabilitation) for improving walking speed in patients with chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Note: However, a fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. found that lower extremity mirror therapy was more effective than sham mirror therapy for improving walking speed. The studies differed in the intensity and duration of intervention, as well as the type of mirror therapy and comparison intervention provided.

One fair quality RCT (Wang et al., 2017) investigated the effect of lower extremity mirror therapy on balance in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity mirror therapy or sham mirror therapy; both groups received conventional rehabilitation. Balance was measured by the Berg Balance Scale at post-treatment (6 weeks). No significant between-group difference was found.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison intervention (sham mirror therapy) for improving balance in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Ji et al., 2014) investigated the effect of lower extremity mirror therapy on gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCT randomized patients with subacute / chronic strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity mirror therapy, lower extremity mirror therapy + functional electrical stimulation (FES), or sham mirror therapy; all participants received additional rehabilitation. GaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
was measured by a three-dimensional motion capture system (velocity, cadence, step length and stride length) at post-treatment (6 weeks). A significant between-group difference in one measure (velocity) was found, in favour of lower extremity mirror therapy vs. sham mirror therapy.
Note: There were significant between-group differences in three measures of gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
(velocity, step length, stride length), in favour of mirror therapy + FES vs. sham mirror therapy. There were no significant differences between lower extremity mirror therapy vs. mirror therapy + FES.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is not more effective than a comparison intervention (sham mirror therapy) for improving gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Note: Mirror therapy with FES was more effective than sham mirror therapy for improving gaitThe pattern of walking, which is often characterized by elements of progression, efficiency, stability and safety.
following strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One poor quality RCT (Kawakami et al., 2015) investigated the effect of mirror therapy on lower extremity motor function in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This poor quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive (i) lower extremity mirror therapy, (ii) integrated volitional-control electrical stimulation, (iii) therapeutic electrical stimulation, (iv) repetitive facilitative exercises, or (v) facilitated movement. Lower extremity motor function was measured by the StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. Impairment Assessment Set (Hip flexion test, Knee extension test, Foot pad test) at post-treatment (4 weeks). No significant between-group differences were found.

Conclusion: There is limited evidence (Level 2b) from one poor quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that mirror therapy is not more effective than comparison interventions (integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, facilitated movement) for improving lower extremity motor function in patients with stroke.

One fair quality RCT (Wang et al., 2017) investigated the effect of lower extremity mirror therapy on motor recovery in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. This fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. randomized patients with acute/subacute strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. to receive lower extremity mirror therapy or lower extremity sham mirror therapy; both groups received conventional rehabilitation. Motor recovery was measured by the Brunnstrom stages of motor recovery at post-treatment (6 weeks). A significant between-group difference was found, in favour of mirror therapy vs. sham mirror therapy.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving lower extremity motor recovery in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

One fair quality RCT (Wang et al., 2017) investigated the effect of lower extremity mirror therapy on walking in patients with stroke. This fair quality RCT randomized patients with acute/subacute stroke to receive lower extremity mirror therapy or lower extremity sham mirror therapy; both groups received conventional rehabilitation. Walking was measured by the Functional AmbulationThe ability to walk, with or without the aid of appropriate assistive devices (such as canes or walkers), safely and sufficiently to carry out mobility-related activities of daily living (ADLs). From Perry et al (1995), functional ambulation is referred to as walking in parallell bars for exercise at a speed of about 10/cm per second.
Categories and the Functional Independence Measure (Locomotion subtest) at post-treatment (6 weeks). Significant between-group differences were found on both measures, in favour of mirror therapy vs. sham mirror therapy.

Conclusion: There is limited evidence (Level 2a) from one fair quality RCTA randomized controlled trial (RCT) is an experimental design in which subjects are randomly assigned to a treatment group, or to a control (no treatment or alternative treatment) group. Effects of the experimental treatment are then compared statistically to results of the control treatment to determine effectiveness. that lower extremity mirror therapy is more effective than a comparison intervention (sham mirror therapy) for improving walking in patients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..