Q. Can mirror therapy help stroke patients regain use of paralyzed limbs?
A. Mirror therapy may provide some improvement in the ability to move limbs affected by stroke, according to a recent review of 62 studies on this rehabilitative treatment. The therapy is used to help people who are paralyzed on one side of the body (hemiplegia) or have muscle weakness on one side (hemiparesis).
In mirror therapy (also called mirror box therapy), someone who has hemiplegia or hemiparesis sits at a table with a specially designed mirror or a mirror “box” in front of him or her; the mirror stands upright but is turned sideways. If a leg is paralyzed, a mirror is positioned on a bench.
The patient places the healthy limb opposite the reflective side of the mirror and the paralyzed limb behind the mirror on the nonreflective side so it is out of view. While looking into the mirror, the patient performs a variety of exercises with the healthy limb, such as stretching the fingers and flexing the elbow and wrist, which creates the illusion that his or her affected limb is performing the movements.
The exact mechanisms that drive the effects of mirror therapy in people who have had a stroke are unclear. In theory, mirror therapy works by activating nerve cells in the brain that respond when you move a limb, as well as when you see a limb move. The review noted above, published in the Cochrane Database of Systematic Reviews in 2018, found that it modestly improves limb movement and the ability to perform daily activities as part of an overall rehabilitation plan.
One benefit of mirror therapy is that it can be performed at home by the patient without a therapist present. On average, the patients in the study—whose ages ranged from 30 to 73—did the exercises for 30 minutes per session, five times a week, for four weeks.
This article first appeared in the August 2019 issue of UC Berkeley Health After 50.
Also see 13 Key Facts About Strokes.