Folding Mirror Therapy Box (Hand/Wrist)

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Garry MI, Loftus A, Summers JJ. Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability. Exp Brain Res 2005; 163: 118–122. ↑ Treatment protocols and techniques for mirror therapy are hard to come by, but as seen by the evidence presented above, mirror therapy appears to be the most effective when used in combination with traditional stroke rehabilitation techniques.

During the first few weeks of treatment, mirror therapy stroke exercises will focus on basic flexion and finger extension movements. The patient and therapist will then choose an appropriate next-level exercise based on the limitations of the affected limb. The goal is to gradually increase the range of motion and complexity involved in these exercises. The therapist will suggest many possible options, including incorporating grasping or manipulating an object. To determine the most suitable option, the patient will perform these basic movements with the unaffected limb. Then, as explained in one report on mirror box therapy protocol, “the patient decides together with the therapist which exercise best facilitates a vivid mirror illusion.”Mirror therapy requires specific physical and cognitive capabilities, which can make it inappropriate for some patients. Individuals with severe disabilities following a stroke, or as a result of another condition, may not be able to perform effective mirror therapy. Per mirror therapy protocol, treatment suitability is based on three overall dimensions: affective, cognitive, and physical abilities. In 1999 Ramachandran and Eric Altschuler expanded the mirror technique from amputees to improving the muscle control of stroke patients with weakened limbs. [7] Every year, 15 million individuals suffer strokes worldwide, and approximately five million of those who survive are permanently disabled as a result, according to the World Health Organization. Fortunately, mirror box therapy (MT) is a safe and effective pathway to enhanced motor function for many stroke survivors. In fact, a recent study reported “better recovery on upper limb function in patients treated with MT compared to untreated patients.” Other clinical trials have similarly concluded “that even in the post-acute phase (starting from 6 weeks after stroke), MT seemed to induce a greater recovery of upper limb function in patients with severe hemiparesis.” Neuroplasticity is the brain’s capability to heal and rewire itself after a neurological injury like a stroke. It is best activated through increased repetition of therapeutic exercises, or massed practice. Neuroplasticity strengthens existing neural pathways (connections) and constructs new ones. The more vigorous the neural pathways for a specific function become, the higher the chances of restoring that function. Working with patients with various complex regional pain syndromes can also be challenging. Pharmacological therapies are frequently associated with a variety of side effects. Mind-body modalities are thought to recreate a role. Mirror therapy triggers neuroplasticity by improving the relationship between neurons in the brain and thereby enhances communication between the motor and the sensory cortex.

Jessie, Barbin; Seetha, Vanessa (2016). "The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review". Annals of Physical and Rehabilitation Medicine. 59 (4): 270–275. doi: 10.1016/j.rehab.2016.04.001. PMID 27256539. As to the effect of MT on PLM, the 8 studies concerned reported effectiveness of MT: 4 with a low level of evidence and 4 with a high level of evidence...We cannot recommend MT as a first intention treatment in PLP. The level of evidence is insufficient. Feigin VL, Norrving B. A new paradigm for primary prevention strategy in people with elevated risk of stroke. Int J Stroke. 2014;9:624–626. doi:10.1111/ijs.12300 Unaffected limb placement: The unaffected limb should be placed in a position like the affected limb, with the reflection of the unaffected limb clearly visible in the mirror. Make sure that jewelry is removed to reduce distractions from the patient’s focus on the limb. Also cover any obvious marks such as tattoos or scars.To sufficiently understand how this phenomenon works, researchers focused on two concepts: mirror neurons (Neurons (nerve cells) are activated both when someone performs an action and watches someone else perform the same action) and neuroplasticity. The brain’s capability to reorganize its structure throughout a person’s life. Mirror neurons are neurons in the brain that are activated when you execute a task but are also activated when you look at someone else performing this task. Yet, these mirror neurons are only started if you watch an action that you can perform yourself. Al Sayegb, Samaa; Filén, Tove (2013). "Mirror therapy for Complex Regional Pain Syndrome (CRPS)—A literature review and an illustrative case report". Scandinavian Journal of Pain. 4 (4): 200–207. doi: 10.1016/j.sjpain.2013.06.002. PMID 29913636. S2CID 49297754. The main treatment strategy for CRPS is physical rehabilitation for return of function and mirror therapy is one of many possible strategies to aid in this goal...There appears to be a clear indication for the use of mirror therapy to be included in the multidisciplinary treatment of CRPS types 1 and 2 with a positive effect on both pain and motor function. A diary where the patient documents time using the mirror, types of movements, symptoms and outcomes can be a useful aid to sustain adherence to the treatment regimen. 25 Post-amputation phantom limb pain [ edit ] Ramachandran (right) with his original mirror box A diagram of a mirror box. A patient inserts a whole hand into one hole and the "phantom" hand into the other. When viewed from an angle, an image of two complete hands is created in the brain.