Research Article
Volume 16 Issue 10 - 2020
The Effectiveness of Mirror Therapy in Stroke Rehabilitation: Current Perspective Review
Muslim Khan1*, Sajida Mazhar2, Mahboob-Ur-Rahman3, Muhammad Bin Afsar Jan4, Yousaf Khan5, Zahid Rahman5, Syed Hamid Habib6, Zilli Huma7, Muhammad Salim Javed Ghandapur8 and Yousaf Ali9
1Assistant Professor, Iqra National University-Swat, Pakistan
2Assistant Professor, IPMR-Khyber Medical University Peshawar, Pakistan
3CEO-Mahboob Medical Institute, Peshawar, Pakistan
4Director RCRS-Rahman Medical Institute (RMI), Peshawar, Pakistan
5Lecturer, IPMS-Khyber Medical University, Peshawar, Pakistan
6Assistant Professor, IBMS-Khyber Medical University Peshawar, Pakistan
7Associate Professor, IBMS-Khyber Medical University Peshawar, Pakistan
8Director-Swat Campus, Iqra National University, Swat, Pakistan
9HOD-Physiotherapy Department, Hayatabad Medical Complex (HMC), Peshawar, Pakistan
*Corresponding Author: Muslim Khan, Assistant Professor, Iqra National University-Swat, Pakistan.
Received: August 19, 2020; Published: September 30, 2020


As compared to the other stroke-related therapies Mirror therapy (MT) in the stroke rehabilitation can be used in all type of stroke survivors (severe and non-severe) visual stimulus is being used for initiating a desirable motor response in limbs of the stroke patient. Literature shows that MT has considerable measurable effects on the motor impairments, visuospatial neglect, sensory impairment and pain/discomfort. This paper is a review of the current perspective and understanding on the MT in the rehabilitation of the stroke survivors. An electronic data base search across the Pub Med, Google Scholar, and Science direct, Cochrane etc. generated 3871 result. Based on the inclusion criteria’s set for the study, 35 studies were included in this review after the systematic filtration of the papers. The collected data were divided on the basis of the it’s (MT) application in the stroke rehabilitation, its intervention’s mode, dosage, type of control and outcome assessment. We found that majority of the selected studies were intervened for motor impairment mostly in the stroke survivors within the upper limb. Studies were categorized in to groups based on the intervention between chronic and acute phase stroke with the therapy duration 1 - 8 weeks. Across all the selected studies MT showed significant motor improvement than the sensory improvement in the stroke survivors. The effectiveness and feasibility of MT has been reported (both for the patients and staff) and commonly used therapeutic approach in the rehabilitation of the post-stroke survivors in all stroke’s stages. However, ADLs based longer term effectiveness of MT and on overall health needs to be further investigated and documented.

Keywords: Mirror Therapy; Stroke Rehabilitation; Motor Impairment; Sensory Impairment; Pain; Unilateral Neglect; Hemi-Neglect


    1. Fong DS., et al. “Diabetic retinopathy”. Diabetes Care1 (2003): s99-s102.
    2. Engelgau MM., et al. “The evolving diabetes burden in the United States”. Annals of Internal Medicine 11 (2004): 945-950.
    3. Kumar V., et al. “Diabetes mellitus”. In: Schmitt W, Gruliow R, editors. Robbins and Cotran pathologic basis of disease. 8th Philadelphia: Elsevier Inc (2007): 775-787.
    4. Mohamed Q., et al. “Management of diabetic retinopathy a systematic review”. The Journal of the American Medical Association 8 (2007): 902-916.
    5. Nentwich MM and Ulbig MW. “Diabetic retinopathy - ocular complications of diabetes mellitus”. World Journal of Diabetes 3 (2015): 489-499.
    6. D’Aloisio R., et al. “Diagnostic accuracy of digital retinal fundus image analysis in detecting diabetic maculopathy in type 2 diabetes mellitus”. Ophthalmic Research 2 (2019): 100-106.
    7. Youngquist RC., et al. “Optical coherence-domain reflectometry: a new optical evaluation technique”. Optics Letters 3 (1987): 158-160.
    8. Virgili G., et al. “Optical coherence tomography (OCT) for detection of macular oedema in patients with diabetic retinopathy”. Cochrane Database of Systematic Reviews 1 (2015): CD008081.
    9. Sim DA., et al. “Quantitative analysis of diabetic macular ischemia using optical coherence tomographyoct features of diabetic macular ischemia”. Investigative Ophthalmology and Visual Science 1 (2014): 417-423.
    10. Hagag AM., et al. “Optical coherence tomography angiography: Technical principles and clinical applications in ophthalmology”. Taiwan Journal of Ophthalmology 3 (2017): 115-129.
    11. Ang M., et al. “Optical coherence tomography angiography: a review of current and future clinical applications”. Graefe's Archive for Clinical and Experimental Ophthalmology 2 (2018): 237-245.
    12. Park JJ., et al. “Characterization of the middle capillary plexus using optical coherence tomography angiography in healthy and diabetic eyes”. Retina 36 (2016): 2039-2050.
    13. Sophie B., et al. “New insight into the macular deep vascular plexus imaged by optical coherence tomography angiography”. Retina 35 (2015): 2347- 2352.
    14. Spaide RF., et al. “Optical coherence tomography angiography”. Progress in Retinal and Eye Research (2018).
    15. Wilkinson CP., et al. “Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales”. Ophthalmology9 (2003): 1677-1682.
    16. Shimizu K., et al. “Midperipheral fundus involvement in diabetic retinopathy”. Ophthalmology7 (1981): 601-612.
    17. Niki T., et al. “Distribution of capillary non- perfusion in early-stage diabetic retinopathy”. Ophthalmology 91 (1984): 1431-1439.
    18. Garcia CR., et al. “Oral fluorescein angiography with the confocal scanning laser ophthalmoscope”. Ophthalmology 106 (1999): 1114-1118.
    19. Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group”. Ophthalmology 98 (1991): 807-822.
    20. Akihiro Ishibazawa., et al. “Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study”. American Journal of Ophthalmology 1 (2015): 35-44.
    21. Freiberg FJ., et al. “Optical coherence tomography angiography of the foveal avascular zone in diabetic retinopathy”. Graefe's Archive for Clinical and Experimental Ophthalmology 6 (2016): 1051-1058.
    22. Snodderly DM., et al. “Neural- vascular relationships in central retina of macaque monkeys (Macaca fascicularis)”. The Journal of Neuroscience 4 (1992): 1169-1193.
    23. Weinhaus RS., et al. “Comparison of fluorescein angiography with microvascular anatomy of macaque retinas”. Experimental Eye Research 1 (1995): 1-16.
    24. Joseph H., et al. “Comparison of 3 mm × 3 mm versus 6 mm × 6 mm optical coherence tomography angiography scan sizes in the evaluation of non -proliferative diabetic retinopathy”. Retina 39 (2019): 259-264.
    25. Bresnick GH., et al. “Abnormalities of the foveal avascular zone in diabetic retinopathy”. Archives of Ophthalmology 9 (1984): 1286-1293.
    26. Lee J and Rosen R. “Optical coherence tomography angiography in diabetes”. Current Diabetes Reports 16 (2016): 123.
    27. Lauermann JL., et al. “Impact of eye-tracking technology on OCT-angiography imaging quality in age-related macular degeneration”. Graefe's Archive for Clinical and Experimental Ophthalmology 8 (2017): 1535-1542.
    28. Camino A., et al. “Automated registration and enhanced processing of clinical optical coherence tomography angiography”. Quantitative Imaging in Medicine and Surgery 4 (2016): 391-401.
    29. Ghasemi Falavarjani K., et al. “Image artefacts in swept-source optical coherence tomography angiography”. British Journal of Ophthalmology 5 (2017): 564-568.
    30. Hagag M., et al. “Optical coherence tomography angiography: Technical principles and clinical applications in ophthalmology”. Taiwan Journal of Ophthalmology 3 (2017): 115-129.
    31. Dmuchowska DA., et al. “Can optical coherence tomography replace fluorescein angiography in detection of ischemic diabetic maculopathy”. Graefe's Archive for Clinical and Experimental Ophthalmology 5 (2014): 731-738.
Citation: Muslim Khan., et al. “The Effectiveness of Mirror Therapy in Stroke Rehabilitation: Current Perspective Review”. EC Dental Science 12.10 (2020): 69-80.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 08, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to