Mirror therapy improves motor function after stroke

Mirror therapy improves motor function after stroke

Brian McAvoy
Clinical question

Compared with no treatment, placebo or sham therapy, or other treatments, how effective is mirror therapy (MT) in improving motor function, motor impairment, activities of daily living, pain and visuospatial neglect after stroke involving a paralysed arm or leg?

Bottom line

MT moderately improved movement of the affected upper and lower limb and the ability to carry out daily activities for people within and also beyond 6 months after the stroke. MT reduced pain after stroke, but mainly in people with a complex regional pain syndrome. There was no clear effect for visuospatial neglect. The beneficial effects on movement were maintained for 6 months, but not in all study groups. No adverse effects were reported. MT was provided 3 to 7 times a week, between 15 and 60 minutes for each session over 2 to 8 weeks (on average, 5 times a week, 30 minutes a session for 4 weeks).


The studies provide moderately reliable evidence that MT improved movement (motor function, motor impairment) and the performance of daily activities. However, there was only low-reliability evidence that MT decreased pain and visuospatial neglect. This may be due to the small number of studies.


MT is a rehabilitation therapy in which a mirror is placed between the arms or legs so that the image of a moving non‐affected limb gives the illusion of normal movement in the affected limb. With this set-up, different brain regions for movement, sensation and pain are stimulated. However, the precise working mechanisms of mirror therapy are still unclear.

Cochrane Systematic Review

Thiere H et al. Mirror therapy for improving motor function after stroke. Cochrane Reviews, 2018, Issue 7. Art. No.: CD008449.DOI: 10.1002/14651858. CD084492.pub3. This review contains 62 studies involving 1982 participants.