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How To Use Mirror Therapy

Stroke Patient

Before You Start

Firstly, you must decide if you (or the patient) is someone who can benefit from mirror therapy. The most important thing is that you can cognitively engage in the process. If you have reduced cognitive function, you will not fully understand the process and it won’t be effective. You also need to have a moderate level of stamina as each activity needs to be carried out at least 15 repetitions. You must also be able to sustain a fairly good sitting posture a chair/wheelchair to look at the mirror. If you fatigue too quickly you will not benefit.

Once you have decided mirror therapy is for you, you can use this mirror therapy protocol.


Mirror therapy can be performed at home. For your brain to believe the optical illusion of the mirror, it needs to focus. You need to be in a quiet room, free of distractions. You need to make sure your mirror/mirror box is big enough for a complete optical illusion. Make sure you are sitting comfortably with the affected limb fully hidden. Remove all jewelry or obvious marks to make both limbs as similar as possible. Spend some time just looking at the reflection of the good limb to allow the brain to start to be tricked into thinking this is you affected limb.

Mirror Therapy Exercises

Depending on what you are trying to achieve, you can decide on which type of activities you want to carry out. Advice for this is given in “Mirror Box Therapy Exercises for Hands & Legs” article. The general rule of thumb is that the more severe the weakness or pain, the smaller the movements should be. Make sure you can complete 15 repetitions of the movement before moving on to something else and stay focused on the illusion in the mirror box at all times. You should never work so hard that you cause more pain in the affected limb.

It has been suggested that as long as movements are bilateral and synchronised, the actual type of movement is not that important. All movements should be carried out slowly to help intensify the mirror illusion. Once you are very confident with the movement you can subsequently create a more difficult environment such as using an object or signing at the same time. If your effected limb does become painful, stop and take a break. You will not have injured the limb but it may be tired so don’t push it as far next time.

Session Length & Duration

Recommendations on length of sessions vary. If you have your own physiotherapist, follow his/her instructions. Royal National Hospital for Rheumatic Diseases in Bath, UK, suggests mirror therapy should be practiced "little and often," for example five times daily for a maximum of five minutes each. However, it is more widely advised to perform mirror therapy at least once daily with a minimum duration of ten minutes. The maximum duration is dependent on your abilities, but in most cases, will be around 30 minutes.

Find out more on the Types Of Mirror Therapy Exercises You Can Do At Home.

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McCabe CS, Haigh RC, Blake DR. (2008) Mirror visual feedback for the treatment of complex regional pain syndrome (type I). Current Pain and Headache Reports. 12:103-107.
Neuro Orthopaedic Institute (NOI) accessed 29/9/17
Rothgangel AS, Braun SM. (2013). Mirror therapy: Practical protocol for stroke rehabilitation. Munich: Pflaum Verlag. doi: 10.12855/
Rothgangel AS, Braun SM, Beurskens AJ, Seitz RJ, Wade DT. (2011) The clinical aspects of mirror therapy in rehabilitation: a systematic review of the literature. Int J Rehabil Res 1: 1-13
Thieme H, Mehrholz J, Pohl M, Behrens J, Dohle C. (2012). Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev14; 3: CD008449