Mirror Therapy in Neuro Rehabilitation: How Visual Feedback Helps the Brain Heal
Our brains rely heavily on sight to help validate what we feel in our bodies. An injury, stroke or amputation will cause disruption in the communication between limbs and the brain causing confusion in the central nervous system. This causes chronic pain, stiffness and immobility.
Mirror therapy is a well-established and non-invasive neuro-rehabilitation technique which uses a mirror to trick the brain into seeing a normal working limb. This then helps to retrain the brain into improving the control of movement and decreasing chronic pain by retraining the motor/sensory cortex of the brain.
The Science Behind Mirror Therapy
Mirror therapy uses neuroplasticity to its advantage. This means the brain can change its pathways and form new connections.
If the arm or leg is paralysed/ amputated the cortical map (mental map of the limb) remains fully formed but doesn't receive any normal sensory feedback. This causes the brain to become distressed and can cause severe phantom pain.
Using a mirror:
The mirror is placed upright in the middle of the body to separate the two limbs. The affected/amputated limb is placed behind the mirror and the patient looks at the reflection of their healthy limb.
The brain sees the limb moving easily with no pain.
This causes the motor areas of the brain (both sides) to become active and encourage unused connections to become active.
Conditions Treated
Stroke rehab - Often people will have weakness, stiffness and/or paralysis on one side of their body following a stroke. Watching the healthy hand move can cause strong bilateral activation in the brain. This helps to improve motor planning,reduce stiffness and improve functional movement in the paretic hand/arm.
Phantom Limb Pain - Many people will feel their missing limb is still there following an amputation. Often the limb will feel tight and in a clenched position. As the limb is missing the brain cannot tell it to relax. Using mirror therapy the patient will see the remaining healthy limb move and therefore the missing limb will appear to open up providing much relief from phantom spasms.
Complex Regional Pain Syndrome (CRPS) - This is a severe chronic pain condition affecting usually the arm or leg following an injury or surgery. It causes burning pain, hypersensitivity to light touch and swelling. The brain becomes very sensitive to the sensory map.Mirror therapy provides a safe source of visual input allowing the patient to watch the limb move without pain and therefore reducing sensitivity.
Post Surgery rehab (hand/nerve) - Often patients will suffer from kinesiophobia and joint stiffness following surgery to repair nerves, tendon transfers and long periods of immobility. Using visual feedback the patient can retrain their fine motor control.
Benefits of Mirror Therapy
Fully non-invasive: Provides huge pain relief and motor stimulation.
No pain: As the therapy is performed using the healthy side there is never any sharp/painful feelings.
Patients can easily do a short session at home once they have been properly assessed and trained by a Physio. They can use a standard mirror box.
Frequently Asked Questions
How long until I see results?
Neurological changes require lots of repetition. Some people with phantom limb pain will feel instant relief however stroke patients will need to do regular daily sessions for 4-8 weeks. This will help improve motor function.
Can anyone with a stroke/nerve injury do this themselves?
Yes they can but they should see a Physio initially. This will ensure the mirror is at the right angle and also prevent mental fatigue. The Physio will also know exactly what movements should be performed. This will avoid you developing incorrect compensatory movements.
