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    Mirror Box Presentation Handout Edited

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    Mirror therapy is a rehabilitation technique that uses a mirror box to create the visual illusion that a patient's affected limb is moving when they move their unaffected limb. This stimulates brain areas involved in movement and can help reduce pain and improve motor function in the affected limb. A mirror box is usually a box or pyramid shape that allows the patient to place their unaffected limb in front and the affected limb behind a mirror. Various exercises can then be done with the unaffected limb to stimulate movement of the affected limb. Studies have found mirror therapy can moderately improve motor function and reduce pain in patients who have had a stroke. Protocols have been developed to progress mirror therapy treatments for stroke patients from basic to more complex movements.

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    Mirror Box Presentation Handout Edited

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    Mirror therapy is a rehabilitation technique that uses a mirror box to create the visual illusion that a patient's affected limb is moving when they move their unaffected limb. This stimulates brain areas involved in movement and can help reduce pain and improve motor function in the affected limb. A mirror box is usually a box or pyramid shape that allows the patient to place their unaffected limb in front and the affected limb behind a mirror. Various exercises can then be done with the unaffected limb to stimulate movement of the affected limb. Studies have found mirror therapy can moderately improve motor function and reduce pain in patients who have had a stroke. Protocols have been developed to progress mirror therapy treatments for stroke patients from basic to more complex movements.

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    Mirror therapy is a rehabilitation technique that uses a mirror box to create the visual illusion that a patient's affected limb is moving when they move their unaffected limb. This stimulates brain areas involved in movement and can help reduce pain and improve motor function in the affected limb. A mirror box is usually a box or pyramid shape that allows the patient to place their unaffected limb in front and the affected limb behind a mirror. Various exercises can then be done with the unaffected limb to stimulate movement of the affected limb. Studies have found mirror therapy can moderately improve motor function and reduce pain in patients who have had a stroke. Protocols have been developed to progress mirror therapy treatments for stroke patients from basic to more complex movements.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    364 views4 pages

    Mirror Box Presentation Handout Edited

    Uploaded by

    api-364398898
    Mirror therapy is a rehabilitation technique that uses a mirror box to create the visual illusion that a patient's affected limb is moving when they move their unaffected limb. This stimulates brain areas involved in movement and can help reduce pain and improve motor function in the affected limb. A mirror box is usually a box or pyramid shape that allows the patient to place their unaffected limb in front and the affected limb behind a mirror. Various exercises can then be done with the unaffected limb to stimulate movement of the affected limb. Studies have found mirror therapy can moderately improve motor function and reduce pain in patients who have had a stroke. Protocols have been developed to progress mirror therapy treatments for stroke patients from basic to more complex movements.

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    of 4

    Mirror Therapy - Mirror Box

    What is Mirror Therapy?


    Mirror Therapy is a therapeutic technique where a patient observes their non-affected limb in a
    mirror to stimulate movement in their affected limb1,2. This type of treatment is based off of
    motor imagery, which is when an individual mentally practices a motor action without doing the
    movement2,3. The idea of mirror therapy is to “trick” the brain into thinking that the individual is
    moving their affected limb normally, thereby stimulating various areas of the brain involved in
    movement, pain, and sensation to build connections between neurons (neuroplasticity) 2,4.

    What Is A Mirror Box?


    A mirror box is the device used by therapists to create the illusion that the affected limb is moving.
    Mirror boxes are a box or pyramid shape. The patient
    places their affected limb on the opposite side of the
    mirror and the non-affected in front of the mirror to
    perform the movements to create a mirror image that
    appears like the affected limb is moving normally
    along with the non-affected limb1,5.

    The image on the right is similar to the mirror box (Rothgangel and
    created for TIRR and is used for the upper extremity. Braun, 2013)
    The one created is detachable and easily stored.
    Materials to create one include the following: mirror, foam board, duct tape, and two foam block
    mounts6.

    What Patient Population Would Benefit From This Treatment?


    Mirror therapy is used to help increase movement and/or decrease pain in the affected limb for
    conditions like phantom limb pain, stroke, and CRPS utilizing the brain’s preference to favor visual
    feedback over proprioceptive feedback5.

    What Is The Evidential Support For Mirror Therapy?


    Thieme et al. conducted a review to summarize the effectiveness of mirror therapy on improving
    motor function after stroke. The researchers included 62 studies that compared mirror therapy to
    other interventions and found that mirror therapy moderately improved affected upper limb and
    lower limb motor functioning and the ability to complete ADLs. Researchers also concluded that
    mirror therapy reduced pain after stroke, but was more effective with treating pain for patients
    with CRPS (2018)1.

    How Can Mirror Therapy Be Used With The Stroke Population?


    Rothgangel and Braun developed a protocol for mirror therapy for stroke patients. The first
    treatment session involves setting the patient up at the mirror box and having them look into the
    mirror to create the visual illusion of their affected hand moving. After the visual illusion is
    established, you must establish a treatment aim (motor function, neglect, tone, sensibility, pain).
    Figure 1 shows the different treatments aims and the treatment approaches to use with each
    particular aim. The following factor to consider for the patient is the amount of stimuli that will be
    involved in the treatment. This includes deciding between unilateral or bilateral exercises; PROM,
    AAROM, or AROM; and use of exercise materials or manual manipulation based on an individual’s
    ability to process information. Figure 2 shows a flowsheet to guide you how to determine the
    correct treatment approach and proper stimuli6.
    Figure 1- Treatment approach in relation to the aim (Rothgangel and Braun, 2013).
    Figure 2- Amount of stimuli used depending on abilities and preferences of the individual patient (Rothgangel and
    Braun, 2013).

    Exercise/Movement Ideas To Use With The Mirror Box?


    The mirror box created for TIRR has a general instruction handout to plan for a treatment session.
    Rothgangel and Braun developed a 4 step process to progress through training motor function in
    stroke patients seen in Figure 36. In general, the more severe the disability, the more basic motor
    exercises you should start with. Once these have been mastered, progress to more structured and
    challenging exercises, and eventually functional movements. Provided in the toolkit are laterality
    cards. These help a patient to work on left/right discrimination and replicating the image shown
    on the card7. Additionally, functional materials can be used for other treatment ideas. Some
    items have been provided in the kit, but other items in the gym can be used as well.
    Figure 3- Overview and step-by step approach when training motor function (Rothgangel and Braun, 2013).

    Reference List
    1. Thieme H., et al. Mirror therapy for improving motor function after stroke. Cochrane database of systematic
    reviews. 07/2018;7:CD008449. doi: 10.1002/14651858.CD008449.pub3.

    2. McDermott A.O., et al. Mirror therapy - upper extremity. Stoke Engine Web site.
    https://www.strokengine.ca/en/intervention/mirror-therapy/. Updated 2018. Accessed May 18, 2019.

    3. Ogourtsova, T., MSc BSc OT, et al. Motor imagery / mental practice. Stoke Engine Web site.
    https://www.strokengine.ca/en/intervention/motor-imagery-mental-practice/. Updated 2017. Accessed May 18, 2019.

    4. Saebo. Guide to mirror therapy and the benefits of neuroplasticity. Saebo Web site. https://www.saebo.com/guide-
    mirror-therapy-benefits-neuroplasticity/. Updated 2018. Accessed May 18, 2019.

    5. Physiopedia contributors. Mirror therapy. Physiopedia Web site. https://www.physio-pedia.com/Mirror_Therapy.


    Updated 2019. Accessed May 18, 2019.

    6. Rothgangel AS, Braun SM. Mirror therapy: Practical protocol for stroke rehabilitation. 2013.

    7. NOI Group. Recognise flash cards. NOI Products Web site. http://www.noigroup.com/en/Product/BTRFC. Accessed
    May 30, 2019.

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