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Efficacy of Virtual Mirror Therapy vs. Traditional Mirror Therapy in Stroke and Acquired Brain Injury Patients

Laura MacNeil, Denise Johnson, Nitin Seth, Hussein A. Abdullah

Background: Traditional Mirror Therapy (TMT) uses a mirror to reflect the movements of healthy limbs to trick the brain through the visual illusion that the impaired limb is moving as a healthy limb. Virtual Reality (VR) systems present a computer-generated reality to simulate the physical world that a user can interact with via projected images or virtual reality goggles. Virtual Mirror Therapy (VMT), one such application of VR, presents the user with a visual of two limbs moving in a unified mirror motion when in the real world; only the healthy limb is mobile. The effects and impact of TMT and VR systems have been studied previously, but few systems have combined and tested the two methods together in a clinical environment.

Objective: This pilot study aims to evaluate the effectiveness of VMT in comparison with TMT for stroke and braininjured patients to improve impaired upper limb functionality, using clinical assessment tools Chedoke Arm and Hand Assessment Inventory (CAHAI) and Chedoke-McMaster Stroke Assessment (CMSA).

Methods: The design was a clinical pilot Randomized Control Trial (RCT) study with 7 patients (4 subjects TMT, 3 subjects VMT). Each participant received treatment over a 4 to 6-week period. Patients were randomly assigned to receive either TMT or VMT treatment. Clinical assessments were conducted by a blinded assessor at baseline and after 6 weeks of treatment.

Results: Data was compared to determine the effectiveness of VMT vs. TMT in improving upper extremity function in stroke and acquired brain injury patients

Conclusion: Results showed that upper extremity function improved in both VMT and TMT for stroke and acquired brain injury patients. Overall, the results of this pilot RCT showed that the effects of VMT are matched with those of TMT. To determine the full efficacy of virtual mirror therapy a larger scale RCT with more subjects should be conducted to achieve more conclusive results.