Question
Is there a certain amount of active range of motion needed in an affected limb post stroke in order to begin mirror therapy?
Answer
There are no AROM parameters for mirror therapy. There are no known adverse effects of mirror therapy in clients who have suffered a stroke, thus it can be initiated at any stage. Some studies have shown it to be effective for clients with acute strokes and very impaired upper extremities. There have also been studies with mirror therapy in chronic stroke cases. There has been no data comparing the effectiveness of mirror therapy with both of these populations, acute vs. chronic, but there has been data to support the use of mirror therapy with both of these populations separately.
There have been a few studies however showing adverse results using mirror therapy to treat "phantom limb pain" in those with upper or lower extremity amputations. In these studies, some of the participants experienced increased grief and depression with its use.
Other populations that have had some research with mirror therapy are those with orthopedic fractures (ie. wrist) and those with cerebral palsy.
The clinical bottom line with mirror therapy is that evidence supports adding mirror therapy to current post-stroke rehab and it is an inexpensive and easy therapy to administer. If we educate the client, they can perform the mirror therapy exercises on their own which will increase their amount of time in therapeutic activities.
