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How to Use Mirror Therapy to Improve Movement After Stroke

mirror therapy for stroke rehab

Mirror therapy offers an interesting method for regaining mobility after a stroke – even if the hand and arm are paralyzed.

To understand how this process works, you’ll need to know about mirror neurons and neuroplasticity. We’re about to explain both.

Then, at the end of this article, we’ll show you how to do mirror therapy – on your own at home or with a therapist.

How Mirror Therapy Works for Stroke Rehabilitation

Mirror therapy utilizes a tabletop mirror to create a reflection of your arm or hand.

The mirror is always placed over the affected side so that the non-affected side is in the reflection. Then, the patient is using the non-affected arm to do various arm movements/exercises, while watching the reflection in the mirror. This tricks the brain into thinking that you’re moving your affected arm, for example, even though you aren’t.

To understand how this helps with motor recovery after stroke, let’s quickly discuss how mirror therapy got started.

Historically, mirror therapy has been used to help relieve phantom limb pain (where an amputee experiences pain in their amputated limb that isn’t actually there).

Mirror therapy helps relieve this pain (after numerous sessions) by helping the brain recognize and “feel” the arm. As a result, the pain decreases in as little as 3 weeks. But, how?

The answer lies within the difference between motor neurons and mirror neurons.

In order to move your arm, motor neurons fire in the brain that tell your arm to move. But mirror neurons are different. They fire when you perform movement and when you simply see movement.

Mirror therapy provides the visual feedback necessary to help mirror neurons fire. As a result, your brain gets the feedback necessary to spark the rewiring process called neuroplasticity.

Quick Summary

Mirror neurons are part of the brain’s motor system, and they fire when you simply see a movement. Mirror therapy capitalizes on this.

Neuroplasticity & Mirror Therapy

Neuroplasticity is the brain’s ability to reorganize itself, and it’s the key to recovery after stroke.

All throughout life, the brain attempts to be efficient by creating and strengthening different pathways. As pathways become stronger, it becomes easier or more second-nature to accomplish that task.

After a stroke, some of these pathways are damaged. Although you cannot revive the damaged brain tissue, neuroplasticity allows healthy parts of the brain to take over lost function.

When the brain has trouble sending signals to the arm or hand after stroke, for example, neuroplasticity allows new areas of the brain to take over this function.

Neuroplasticity is activated by repetitive stimulus. For example, when you practice hand therapy exercises over and over, it helps the brain rewire itself and strengthen the pathways that control hand function.

Quick Summary

The brain is capable of rewiring itself based on repetitive stimulus. After a stroke, this process allows the brain to recover lost functions.

Benefits of Mirror Therapy

Before we discuss how to do mirror therapy, it helps to get excited over the many possible benefits.

Here are some benefits of mirror therapy for stroke patients:

  • Hand and/or arm paralysis may improve. The most common application for mirror therapy is to improve upper extremity function. This is where we have the most clinical evidence And best of all – patients don’t need any preexisting movement to benefit from this therapy.
  • Activities of daily living become easier. Most therapists strive to help patients get better at self-care tasks like the Activities of Daily Living (ADL). The gains made during mirror therapy are found to translate to the ADLs and improve the patient’s ability to perform self-care.
  • Leg function may improve. Although mirror therapy is often used on the upper extremities, it can also be used to improve leg function. You’ll just need a bigger mirror.
  • Hemineglect may improve. Some believe that mirror therapy may help improve visuospatial neglect, or hemineglect, in stroke patients. There is insufficient clinical evidence for this though.
  • Post-stroke pain may improve. One study found that mirror therapy helps improve post-stroke pain in a patient 5 years after a thalamic stroke. While this study was small and more research is needed, this provides hope for a condition where treatment options are limited.
  • Low-risk treatment. Mirror therapy is considered very safe and affordable, as it simply involves a tabletop mirror and gentle exercises. (You’ll learn more about how to do it soon.)

With all of these benefits, it’s no wonder that mirror therapy is quickly gaining popularity in stroke clinics.

One of the best perks is that you can do mirror therapy with or without the help of a therapist. Although it’s best to get started alongside a therapist, mirror therapy is safe to do on your own at home.

Next, we’ll show you how.

Quick Summary

Mirror therapy can help stroke patients overcome hand and arm paralysis, along with a host of other benefits.

How to Do Mirror Therapy for Stroke Recovery

To illustrate how to do mirror therapy, we will explain how to use it for hand therapy. To work on your arm or leg, you just need to adjust the protocol for that limb.

Here’s a video from Bob and Brad (the “most famous physical therapists on the internet”) that demonstrates mirror therapy:

Here are the steps to perform mirror therapy:

  1. Place a tabletop mirror over your affected arm and hand, with the non-affected arm laying on the table next to the mirror so that it is fully in view in the reflection.
  2. Spend a few minutes observing the reflection and getting situated with the optical illusion.
  3. It can be helpful to think of the mirror as a window, instead of a reflection. This can help further “trick” your brain into thinking that you’re viewing your affected side (even though it’s covered by the reflection of your non-affected side).
  4. Then, practice simple hand therapy exerciseswith your non-affected hand. Some examples include touching your thumb to your fingertips, making a fist and then opening the hand, or turning your palm up and down.
  5. Complete these exercises for at least 10 minutes, working your way up to half-hour sessions. Keep your eyes on the reflection in the mirror the whole time.

You can reference our hand exercises for stroke patients to find other ideas for simple, therapeutic hand movements to try.

It’s important to be strategic and repetitive with your mirror therapy exercises. Randomly wiggling your hand around may provide slight benefit, but the best results will come if you practice specific hand exercises repetitively.

Neuroplasticity is activated by repetition. The more you practice mirror therapy exercises, the more your brain will rewire itself.

Quick Summary

Practicing mirror therapy exercises on a consistent basis will help the brain rewire itself and, ideally, improve hand function.

Mirror Therapy + MusicGlove

The classic thumb-to-fingertip hand exercise is often used in the clinic, and it’s the same movement that MusicGlove hand therapy motivates you to do.

If you’re the creative type, you can try placing MusicGlove on your non-affected hand and play it that way with the mirror therapy.

We have seen therapists do this to help improve hand paralysis in some stroke patients.

This is obviously not a clinically-proven result. Rather, MusicGlove was clinically proven to improve hand function in 2 weeks in patients that had enough movement to use it as intended (without mirror therapy).

But if you’re interested in a creative solution for hand paralysis after stroke, it might help. Plus, MusicGlove is covered by a 30-day guarantee, so you can return the device if it doesn’t benefit you.

Quick Summary

Flint Rehab’s MusicGlove can be combined with mirror therapy to potentially help improve hand paralysis.

Mirror Therapy for Stroke Patients

Overall, mirror therapy is a promising stroke rehabilitation method for stroke patients — especially those with hand or arm paralysis.

It works by “tricking” the brain into thinking that you’re moving your affected side, even though it’s just a reflection. This triggers mirror neurons in the brain to fire, which helps improve motor recovery after stroke.

Try to work with a therapist for at least one session to get acquainted with this therapy before you try it at home. Then, try doing it every day for at least 10 minutes.

Consistency and repetition are key to activating neuroplasticity after stroke. Good luck!

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