Stroke, Ischemicmirror_robotNCT07435688
Comparison of the Effectiveness of Mirror Therapy and Mirror Mode of Hand Robot in Stroke
A study testing Hand Robot Mirror Mode and Therapy Mirror in people with Stroke, Ischemic and Stroke, run by Zeynep Lide Uz at 2 sites in Turkey (Türkiye).
Trial summary
The goal of this clinical trial is to compare the effectiveness of conventional mirror therapy and robotic mirror mode training in promoting upper extremity motor recovery in adult patients with ischemic stroke during the early subacute phase. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Stroke, Ischemic, Stroke, CVA (Cerebrovascular Accident)
- What is being tested?
- Hand Robot Mirror Mode and Therapy Mirror
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 2 sitesTurkey (Türkiye)
- Study dates
- 10 Jan 2024to 10 Dec 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Having a ischemic/hemorrhagic stroke diagnosis through MRI and/or CT
- Volunteering to enter the study
- First ever stroke or no sequeale (mRS 0)
- Being in subacute/chronic phase of stroke (between 1st week to 1 year)
- Having a adequate sitting balance or able to maintain upright sitting position for 30 minutes
- Having a motor deficit in the hand (Brunnstrom hand motor recovery stages 1-4 )
- Having a full range of motion in hand
Who cannot join
- Severe Pain (VAS ≥ 8)
- Having a neurological or orthopedic problem in hand
- Severe spatial hemineglect (NIHSS 11th subscale> 1)
- Spasticity (mAS ≥ 2)
- Apraxia
- Visual/auditory loss that affects treatment
- Unstable Vital Signs
Trial locations and contacts
2 sites in 1 country.
Turkey (Türkiye)2 sites
Istanbul University- Cerrahpasa
Istanbul, Büyükcekmece, 34500
Alkent 2000, 34500 Büyükçekmece/İstanbul
Istanbul, Istanbul, 34500
About this study
Official title: Comparison of The Effectiveness Of Mirror Therapy And Mirror Mode of a Hand Robot in Upper Extremity Motor Recovery After Stroke
The goal of this clinical trial is to compare the effectiveness of conventional mirror therapy and robotic mirror mode training in promoting upper extremity motor recovery in adult patients with ischemic stroke during the early subacute phase. The main questions it aims to answer are:
Does mirror mode of a robotic hand device result in greater motor function recovery compared to conventional mirror therapy?
Read more
Are there differences between the groups in somatosensory improvement and gross motor skill outcomes?
Do both intervention modalities result in clinically significant improvements in motor and functional outcomes?
Researchers will compare a conventional mirror therapy group and a robotic-assisted mirror mode group to determine which provides more significant gains in motor function, somatosensory input, and functional use of the paretic arm.
Participants will:
Receive standard physiotherapy sessions for 6 weeks
Be randomly assigned to either mirror therapy or robotic mirror mode intervention
Be evaluated using Fugl-Meyer Assessment, ARAT, Box and Block Test, Wolf Motor Function Test and Tactile/proprioceptive sensory test using Fugl-Meyer Assessment Sensory subsection.
Read the detailed description
Upper extremity motor impairment is one of the leading causes of functional disability following stroke. Although conventional therapies promote some degree of recovery, restoring hand function remains a major challenge, particularly in patients with severe paresis. Mirror therapy has been widely used due to its affordability and portability. However, proprioceptive feedback limitations and the potential mismatch between visual and somatosensory input reduce its effectiveness.
This study investigates an innovative approach that combines visual illusion and proprioceptive input using a robotic hand device in mirror mode. The robotic intervention is designed to synchronize joint motion with visual feedback, potentially enhancing the mirror neuron system's activation and promoting neuroplastic changes more efficiently than conventional mirror therapy.
The study will be conducted over a 6-week period with stroke patients in the early subacute phase. Both groups will receive equivalent durations of upper limb training in addition to conventional physiotherapy.
This trial aims not only to compare motor outcomes but also to evaluate whether motor improvements translate into functional hand use and to explore differences in somatosensory gains between interventions. By addressing both visual and proprioceptive components of motor learning, this research may guide future clinical strategies for individualized stroke rehabilitation.
- Conditions
- Stroke, Ischemic, Stroke, CVA (Cerebrovascular Accident)
- Being tested
- Hand Robot Mirror Mode, Therapy Mirror
- Keywords
- robotic rehabilitation, mirror therapy, stroke rehabilitation, neurorehabilitation
- Medical subject headings
- Ischemic Stroke, Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Hand Robot Mirror ModeDevice
Also called Syrebo C12 / SY-HRC12
Mirror mode of the hand robot group will mimic the movement of the unaffected arm. The robot will provide proprioceptive and visual feedback and make patient believe that the affected arm is moving.
Therapy MirrorDevice
Patients in the mirror therapy group will glance at the reflection of their non-affected arm and fall into the illusion that their non-affected limb is moving. This is supposed to assist patients regain motor deficits by reducing non-use paralysis.
| Study group | Role | What they receive |
|---|---|---|
| Mirror Therapy Group | Active comparator | The group who receives conventional mirror therapy Receives: Device: Therapy Mirror |
| Hand Robot Group | Active comparator | The group who receives mirror mode of a soft robotic glove Receives: Device: Hand Robot Mirror Mode |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fugl Meyer Assesment
The Fugl-Meyer Assessment-Upper Extremity is a stroke-specific, performance-based impairment scale and gold-standard measure of post-stroke motor recovery that quantifies upper limb motor function using a standardized ordinal scoring system assessing reflex activity, movement control, coordination, and joint function.
Measured: 30 minutes
Secondary outcomes (3)
Action Research Arm Test
The Action Research Arm Test (ARAT) is a performance-based assessment designed to evaluate upper limb function by measuring the ability to grasp, grip, pinch, and perform gross motor movements. It is particularly sensitive to changes in hand and arm function after stroke and is frequently used in both clinical and research settings to monitor motor recovery.
Measured: 15 minutes
Wolf Motor Function Test
The Wolf Motor Function Test (WMFT) is a widely used, time-based assessment that evaluates upper extremity motor ability through a series of functional and strength-related tasks in individuals with stroke. It measures both the time taken to complete 15 standardized activities and the quality of movement, providing objective data on motor recovery.
Measured: 30 minutes
Box and Block Test
The Box and Block Test is a standardized, performance-based measure of gross manual dexterity that quantifies upper extremity function by counting the number of blocks transferred within 60 seconds.
Measured: 5 minutes
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Feb 2026
- Study start10 Jan 2024
- Primary completion25 Nov 2024
- Study completion10 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for Stroke, IschemicStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- Zeynep Lide Uz
- Sponsor type
- University, hospital or other
- Collaborators
- The Scientific and Technological Research Council of Turkey, Istanbul University - Cerrahpasa
- Responsible party
- Sponsor-investigator, Zeynep Lide Uz, Istanbul University - Cerrahpasa
- Investigators
- Ela Tarakcı, 1, Study director, Istanbul University- Cerrahapaşa
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07435688
- Sponsor's protocol ID
- Robot/Mirror in Stroke
- Other IDs
- 223S419
- Acronym
- mirror_robot
- Status last verified
- Feb 2026
- First submitted
- 18 Jun 2025
- Last updated
- 15 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Arya KN, Verma R, Garg RK. Estimating the minimal clinically important difference of an upper extremity recovery measure in subacute stroke patients. Top Stroke Rehabil. 2011 Oct;18 Suppl 1:599-610. doi: 10.1310/tsr18s01-599.
PubMed 22120029Baniqued PDE, Stanyer EC, Awais M, Alazmani A, Jackson AE, Mon-Williams MA, Mushtaq F, Holt RJ. Brain-computer interface robotics for hand rehabilitation after stroke: a systematic review. J Neuroeng Rehabil. 2021 Jan 23;18(1):15. doi: 10.1186/s12984-021-00820-8.
PubMed 33485365Chien WT, Chong YY, Tse MK, Chien CW, Cheng HY. Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients: A systematic review and meta-analysis. Brain Behav. 2020 Aug;10(8):e01742. doi: 10.1002/brb3.1742. Epub 2020 Jun 26.
PubMed 32592282Faria-Fortini I, Michaelsen SM, Cassiano JG, Teixeira-Salmela LF. Upper extremity function in stroke subjects: relationships between the international classification of functioning, disability, and health domains. J Hand Ther. 2011 Jul-Sep;24(3):257-64; quiz 265. doi: 10.1016/j.jht.2011.01.002. Epub 2011 Mar 21.
PubMed 21420279Ho NS, Tong KY, Hu XL, Fung KL, Wei XJ, Rong W, Susanto EA. An EMG-driven exoskeleton hand robotic training device on chronic stroke subjects: task training system for stroke rehabilitation. IEEE Int Conf Rehabil Robot. 2011;2011:5975340. doi: 10.1109/ICORR.2011.5975340.
PubMed 22275545Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995 Jan;76(1):27-32. doi: 10.1016/s0003-9993(95)80038-7.
PubMed 7811170Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003 Sep;34(9):2181-6. doi: 10.1161/01.STR.0000087172.16305.CD. Epub 2003 Aug 7.
PubMed 12907818Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev. 2018 Sep 3;9(9):CD006876. doi: 10.1002/14651858.CD006876.pub5.
PubMed 30175845Nakayama H, Jorgensen HS, Raaschou HO, Olsen TS. Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1994 Apr;75(4):394-8. doi: 10.1016/0003-9993(94)90161-9.
PubMed 8172497Raine, S., Meadows, L., & Lynch-Ellerington, M. (2009). Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation. In Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation. https://doi.org/10.1002/9781444314601
Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2018 Jul 11;7(7):CD008449. doi: 10.1002/14651858.CD008449.pub3.
PubMed 29993119
Study at a glance
From the registry record, last updated by the sponsor on 15 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of The Effectiveness Of Mirror Therapy And Mirror Mode of a Hand Robot in Upper Extremity Motor Recovery After Stroke
- ClinicalTrials.gov ID
- NCT07435688
- Acronym / sponsor ID
- mirror_robot / Robot/Mirror in Stroke
- Conditions
- Stroke, Ischemic, Stroke, CVA (Cerebrovascular Accident)
- Keywords
- robotic rehabilitation, mirror therapy, stroke rehabilitation, neurorehabilitation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Zeynep Lide UzUniversity, hospital or other
- Collaborators
- The Scientific and Technological Research Council of Turkey, Istanbul University - Cerrahpasa
- Study start
- 10 Jan 2024 (actual)
- Primary completion
- 25 Nov 2024 (actual)
- Study completion
- 10 Dec 2024 (actual)
- First posted
- 27 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to compare the effectiveness of conventional mirror therapy and robotic mirror mode training in promoting upper extremity motor recovery in adult patients with ischemic stroke during the early subacute phase. The main questions it aims to answer are:
Does mirror mode of a robotic hand device result in greater motor function recovery compared to conventional mirror therapy?
Are there differences between the groups in somatosensory improvement and gross motor skill outcomes?
Do both intervention modalities result in clinically significant improvements in motor and functional outcomes?
Researchers will compare a conventional mirror therapy group and a robotic-assisted mirror mode group to determine which provides more significant gains in motor function, somatosensory input, and functional use of the paretic arm.
Participants will:
Receive standard physiotherapy sessions for 6 weeks
Be randomly assigned to either mirror therapy or robotic mirror mode intervention
Be evaluated using Fugl-Meyer Assessment, ARAT, Box and Block Test, Wolf Motor Function Test and Tactile/proprioceptive sensory test using Fugl-Meyer Assessment Sensory subsection.
Detailed description
Upper extremity motor impairment is one of the leading causes of functional disability following stroke. Although conventional therapies promote some degree of recovery, restoring hand function remains a major challenge, particularly in patients with severe paresis. Mirror therapy has been widely used due to its affordability and portability. However, proprioceptive feedback limitations and the potential mismatch between visual and somatosensory input reduce its effectiveness.
This study investigates an innovative approach that combines visual illusion and proprioceptive input using a robotic hand device in mirror mode. The robotic intervention is designed to synchronize joint motion with visual feedback, potentially enhancing the mirror neuron system's activation and promoting neuroplastic changes more efficiently than conventional mirror therapy.
The study will be conducted over a 6-week period with stroke patients in the early subacute phase. Both groups will receive equivalent durations of upper limb training in addition to conventional physiotherapy.
This trial aims not only to compare motor outcomes but also to evaluate whether motor improvements translate into functional hand use and to explore differences in somatosensory gains between interventions. By addressing both visual and proprioceptive components of motor learning, this research may guide future clinical strategies for individualized stroke rehabilitation.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Mirror Therapy Group | Active comparator | Device: Therapy MirrorThe group who receives conventional mirror therapy |
| Hand Robot Group | Active comparator | Device: Hand Robot Mirror ModeThe group who receives mirror mode of a soft robotic glove |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Having a ischemic/hemorrhagic stroke diagnosis through MRI and/or CT
- Volunteering to enter the study
- First ever stroke or no sequeale (mRS 0)
- Being in subacute/chronic phase of stroke (between 1st week to 1 year)
- Having a adequate sitting balance or able to maintain upright sitting position for 30 minutes
Key exclusion criteria (7 listed)
- Severe Pain (VAS ≥ 8)
- Having a neurological or orthopedic problem in hand
- Severe spatial hemineglect (NIHSS 11th subscale> 1)
- Spasticity (mAS ≥ 2)
- Apraxia
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Hand Robot Mirror ModeAlso: Syrebo C12 / SY-HRC12Mirror mode of the hand robot group will mimic the movement of the unaffected arm. The robot will provide proprioceptive and visual feedback and make patient believe that the affected arm is moving. | Device | Hand Robot Group |
| Therapy MirrorPatients in the mirror therapy group will glance at the reflection of their non-affected arm and fall into the illusion that their non-affected limb is moving. This is supposed to assist patients regain motor deficits by reducing non-use paralysis. | Device | Mirror Therapy Group |
Primary outcome
Fugl Meyer Assesment
Time frame: 30 minutes
The Fugl-Meyer Assessment-Upper Extremity is a stroke-specific, performance-based impairment scale and gold-standard measure of post-stroke motor recovery that quantifies upper limb motor function using a standardized ordinal scoring system assessing reflex activity, movement control, coordination, and joint function.
3 secondary outcomes
Action Research Arm Test
Time frame: 15 minutes
Wolf Motor Function Test
Time frame: 30 minutes
Box and Block Test
Time frame: 5 minutes
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Apr 2026.
- Background: PubMed 22120029Arya KN, Verma R, Garg RK. Estimating the minimal clinically important difference of an upper extremity recovery measure in subacute stroke patients. Top Stroke Rehabil. 2011 Oct;18 Suppl 1:599-610. doi: 10.1310/tsr18s01-599.
- Background: PubMed 33485365Baniqued PDE, Stanyer EC, Awais M, Alazmani A, Jackson AE, Mon-Williams MA, Mushtaq F, Holt RJ. Brain-computer interface robotics for hand rehabilitation after stroke: a systematic review. J Neuroeng Rehabil. 2021 Jan 23;18(1):15. doi: 10.1186/s12984-021-00820-8.
- Background: PubMed 32592282Chien WT, Chong YY, Tse MK, Chien CW, Cheng HY. Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients: A systematic review and meta-analysis. Brain Behav. 2020 Aug;10(8):e01742. doi: 10.1002/brb3.1742. Epub 2020 Jun 26.
- Background: PubMed 21420279Faria-Fortini I, Michaelsen SM, Cassiano JG, Teixeira-Salmela LF. Upper extremity function in stroke subjects: relationships between the international classification of functioning, disability, and health domains. J Hand Ther. 2011 Jul-Sep;24(3):257-64; quiz 265. doi: 10.1016/j.jht.2011.01.002. Epub 2011 Mar 21.
- Background: PubMed 22275545Ho NS, Tong KY, Hu XL, Fung KL, Wei XJ, Rong W, Susanto EA. An EMG-driven exoskeleton hand robotic training device on chronic stroke subjects: task training system for stroke rehabilitation. IEEE Int Conf Rehabil Robot. 2011;2011:5975340. doi: 10.1109/ICORR.2011.5975340.
- Background: PubMed 7811170Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995 Jan;76(1):27-32. doi: 10.1016/s0003-9993(95)80038-7.
- Background: PubMed 12907818Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003 Sep;34(9):2181-6. doi: 10.1161/01.STR.0000087172.16305.CD. Epub 2003 Aug 7.
- Background: PubMed 30175845Mehrholz J, Pohl M, Platz T, Kugler J, Elsner B. Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke. Cochrane Database Syst Rev. 2018 Sep 3;9(9):CD006876. doi: 10.1002/14651858.CD006876.pub5.
- Background: PubMed 8172497Nakayama H, Jorgensen HS, Raaschou HO, Olsen TS. Recovery of upper extremity function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil. 1994 Apr;75(4):394-8. doi: 10.1016/0003-9993(94)90161-9.
- BackgroundRaine, S., Meadows, L., & Lynch-Ellerington, M. (2009). Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation. In Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation. https://doi.org/10.1002/9781444314601
- Background: PubMed 29993119Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2018 Jul 11;7(7):CD008449. doi: 10.1002/14651858.CD008449.pub3.
- hand robot that will be used in this researchLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ela Tarakcı, 1 study director
Istanbul University- Cerrahapaşa
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Hand Robot Mirror Mode and Therapy Mirror in people with Stroke, Ischemic and Stroke, run by Zeynep Lide Uz at 2 sites in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fugl Meyer Assesment (time frame: 30 minutes). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07435688, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Apr 2026.