StrokeNCT07460128
Digital Mirror Therapy in Stroke Rehabilitation
A study testing digital mirror therapy and conventional mirror therapy in people with Stroke, run by The Hong Kong Polytechnic University at 2 sites in Hong Kong.
Trial summary
Background: While conventional mirror therapy is a Level A recommended rehabilitation for poststroke upper extremity recovery, digital mirror therapy-enabled by augmented reality and computer vision-offers a promising alternative with potential for greater engagement and enriched sensory feedback. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Stroke
- What is being tested?
- digital mirror therapy and conventional mirror therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 2 sitesHong Kong
- Study dates
- 2 Mar 2026to 31 Dec 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- diagnosis of ischemic or hemorrhagic stroke more than 6 months;
- age between 18 and 80 years;
- upper limb function rated at levels 2-6 according to the Functional Test for Hemiplegic Extremity Hong Kong Version
Who cannot join
- any concomitant neurological disease other than stroke;
- signs of cognitive impairment, defined as a score below 6 out of 10 on the Abbreviated Mental Test - Hong Kong Version ;
- or severe spasticity in the hemiparetic upper extremity muscles, with a Modified Ashworth Scale score greater than 2;
- unable to express thoughts effectively through verbal speech or written language.
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Sofina Chan, MA contact
Hong Kong2 sites, 2 recruiting
- Recruiting
Hong Kong Polytechnic University
Hong Kong, 000000
Jack Jiaqi Zhang, 27666696, jack-jiaqi.zhang@polyu.edu.hk
- Recruiting
Hong Kong Polytechnic University
Hong Kong, 000000
Jack Jiaqi Zhang, 6696, jack-jiaqi.zhang@polyu.edu.hk
jack-jiaqi.zhang@polyu.edu.hk
About this study
Official title: Digital Mirror Therapy in Poststroke Rehabilitation: Efficacy and Patient-reported Facilitators and Barriers to Adherence.
Background: While conventional mirror therapy is a Level A recommended rehabilitation for poststroke upper extremity recovery, digital mirror therapy-enabled by augmented reality and computer vision-offers a promising alternative with potential for greater engagement and enriched sensory feedback. However, systematic comparisons of their clinical and physiological benefits, alongside an understanding of patient experiences with digital therapy, are lacking.
Objectives: This randomized controlled trial will compare the efficacy of digital versus conventional mirror therapy for upper extremity rehabilitation in people after chronic stroke. The evaluation will focus on three areas: 1) clinical outcomes in motor function and community integration; 2) musculoskeletal physiological mechanisms, assessed through upper extremity muscle co-activation patterns; and 3) patient-reported barriers and facilitators to adherence with the digital technology. Methods: A parallel-group, assessor-blinded randomized controlled trial will be conducted. Participants with chronic stroke will be randomized to receive either digital or conventional mirror therapy three times per week for a total of 10 sessions over 21 days. The quantitative outcomes will be upper extremity function (using clinical scales), community integration (using a dedicated scale), and muscle activation/co-activation patterns during functional tasks (measured via surface electromyography [EMG]). The qualitative outcome will be patient-experienced barriers and facilitators, which will be explored through focus groups. Expected Results: This project aims to determine whether digital mirror therapy yields superior clinical outcomes compared to the conventional protocol. We hypothesize that greater improvement in upper extremity motor function will be associated with increased voluntary activation of task-relevant muscles and a reduction in abnormal co-contraction patterns. Furthermore, the qualitative findings will provide insights into the practical facilitators and barriers to patient adherence to digital technological rehabilitation, which will guide its future development and real-world clinical implementation.
- Conditions
- Stroke
- Being tested
- digital mirror therapy, conventional mirror therapy
- Keywords
- Stroke, Observational imitation training, Mirror therapy, Upper extremity
- Medical subject headings
- Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
digital mirror therapyBehavioural
In the digital mirror therapy, we will use a self-developed digital visual feedback system to deliver the intervention. We will design 6-8 upper limb functional training tasks for each patient, according to the level of upper extremity functioning. Patients will complete these tasks under the guidance of the investigator during each training session. The digital mirror therapy will be delivered through an augmented reality system with virtual objects and enhanced visual feedback onto the patient's view of their affected upper extremity. Each task will be repeated 20 times per session, with the total duration of each session being approximately 45-60 minutes.
conventional mirror therapyBehavioural
The conventional mirror therapy group will receive the identical dose and structure of training but using a physical mirror. The therapy will be performed using a conventional mirror and common physical objects for task-oriented practice. Both groups will participate three times per week in a maximal period of 21 days, for a total of 10 training sessions.
| Study group | Role | What they receive |
|---|---|---|
| digital mirror therapy | Experimental | For the digital mirror therapy, we will use a self-developed digital visual feedback system to deliver the intervention. We will design 6-8 upper limb functional training tasks for each patient, according to the level of upper extremity functioning. Patients will complete these tasks under the guidance of the investigator during each training session. The digital mirror therapy will be delivered through an augmented reality system with virtual objects and enhanced visual feedback onto the patient's view of their affected upper extremity. Each task will be repeated 20 times per session, with the total duration of each session being approximately 45-60 minutes. Participants will participate three times per week in a maximal period of 21 days, for a total of 10 training sessions. Receives: Behavioral: digital mirror therapy |
| conventional mirror therapy | Active comparator | The conventional mirror therapy group will receive the identical dose and structure of training but using a physical mirror. The therapy will be performed using a conventional mirror and common physical objects for task-oriented practice. They will participate three times per week in a maximal period of 21 days, for a total of 10 training sessions. Receives: Behavioral: conventional mirror therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fugl-Meyer Assessment Upper Extremity Scores
Measured: Baseline
Fugl-Meyer Assessment Upper Extremity Scores
Measured: After 3 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Mar 2026
- Study start2 Mar 2026
- Primary completion31 Dec 2028 (estimated)
- Study completion31 Dec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for StrokeStudies of the same condition, open and under way.
- More trials run by The Hong Kong Polytechnic UniversityThe sponsor's other registered studies.
- 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
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- The Hong Kong Polytechnic University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jack Jiaqi Zhang, Principal investigator, The Hong Kong Polytechnic University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07460128
- Sponsor's protocol ID
- HSEARS20251026004
- Status last verified
- Mar 2026
- First submitted
- 4 Mar 2026
- Last updated
- 10 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 10 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Digital Mirror Therapy in Poststroke Rehabilitation: Efficacy and Patient-reported Facilitators and Barriers to Adherence.
- ClinicalTrials.gov ID
- NCT07460128
- Acronym / sponsor ID
- HSEARS20251026004
- Conditions
- Stroke
- Keywords
- Stroke, Observational imitation training, Mirror therapy, Upper extremity
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 44 participants (estimated)
- Lead sponsor
- The Hong Kong Polytechnic UniversityUniversity, hospital or other
- Study start
- 2 Mar 2026 (actual)
- Primary completion
- 31 Dec 2028 (estimated)
- Study completion
- 31 Dec 2028 (estimated)
- First posted
- 10 Mar 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.
Background: While conventional mirror therapy is a Level A recommended rehabilitation for poststroke upper extremity recovery, digital mirror therapy-enabled by augmented reality and computer vision-offers a promising alternative with potential for greater engagement and enriched sensory feedback. However, systematic comparisons of their clinical and physiological benefits, alongside an understanding of patient experiences with digital therapy, are lacking.
Objectives: This randomized controlled trial will compare the efficacy of digital versus conventional mirror therapy for upper extremity rehabilitation in people after chronic stroke. The evaluation will focus on three areas: 1) clinical outcomes in motor function and community integration; 2) musculoskeletal physiological mechanisms, assessed through upper extremity muscle co-activation patterns; and 3) patient-reported barriers and facilitators to adherence with the digital technology. Methods: A parallel-group, assessor-blinded randomized controlled trial will be conducted. Participants with chronic stroke will be randomized to receive either digital or conventional mirror therapy three times per week for a total of 10 sessions over 21 days. The quantitative outcomes will be upper extremity function (using clinical scales), community integration (using a dedicated scale), and muscle activation/co-activation patterns during functional tasks (measured via surface electromyography [EMG]). The qualitative outcome will be patient-experienced barriers and facilitators, which will be explored through focus groups. Expected Results: This project aims to determine whether digital mirror therapy yields superior clinical outcomes compared to the conventional protocol. We hypothesize that greater improvement in upper extremity motor function will be associated with increased voluntary activation of task-relevant muscles and a reduction in abnormal co-contraction patterns. Furthermore, the qualitative findings will provide insights into the practical facilitators and barriers to patient adherence to digital technological rehabilitation, which will guide its future development and real-world clinical implementation.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| digital mirror therapy | Experimental | Behavioral: digital mirror therapyFor the digital mirror therapy, we will use a self-developed digital visual feedback system to deliver the intervention. We will design 6-8 upper limb functional training tasks for each patient, according to the level of upper extremity functioning. Patients will complete these tasks under the guidance of the investigator during each training session. The digital mirror therapy will be delivered through an augmented reality system with virtual objects and enhanced visual feedback onto the patient's view of their affected upper extremity. Each task will be repeated 20 times per session, with the total duration of each session being approximately 45-60 minutes. Participants will participate three times per week in a maximal period of 21 days, for a total of 10 training sessions. |
| conventional mirror therapy | Active comparator | Behavioral: conventional mirror therapyThe conventional mirror therapy group will receive the identical dose and structure of training but using a physical mirror. The therapy will be performed using a conventional mirror and common physical objects for task-oriented practice. They will participate three times per week in a maximal period of 21 days, for a total of 10 training sessions. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- diagnosis of ischemic or hemorrhagic stroke more than 6 months;
- age between 18 and 80 years;
- upper limb function rated at levels 2-6 according to the Functional Test for Hemiplegic Extremity Hong Kong Version
Key exclusion criteria (4 listed)
- any concomitant neurological disease other than stroke;
- signs of cognitive impairment, defined as a score below 6 out of 10 on the Abbreviated Mental Test - Hong Kong Version ;
- or severe spasticity in the hemiparetic upper extremity muscles, with a Modified Ashworth Scale score greater than 2;
- unable to express thoughts effectively through verbal speech or written language.
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 |
|---|---|---|
| digital mirror therapyIn the digital mirror therapy, we will use a self-developed digital visual feedback system to deliver the intervention. We will design 6-8 upper limb functional training tasks for each patient, according to the level of upper extremity functioning. Patients will complete these tasks under the guidance of the investigator during each training session. The digital mirror therapy will be delivered through an augmented reality system with virtual objects and enhanced visual feedback onto the patient's view of their affected upper extremity. Each task will be repeated 20 times per session, with the total duration of each session being approximately 45-60 minutes. | Behavioural | digital mirror therapy |
| conventional mirror therapyThe conventional mirror therapy group will receive the identical dose and structure of training but using a physical mirror. The therapy will be performed using a conventional mirror and common physical objects for task-oriented practice. Both groups will participate three times per week in a maximal period of 21 days, for a total of 10 training sessions. | Behavioural | conventional mirror therapy |
Primary outcome
Fugl-Meyer Assessment Upper Extremity Scores
Time frame: Baseline
Fugl-Meyer Assessment Upper Extremity Scores
Time frame: After 3 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Mar 2026.
- Individual participant dataSharing planned: Undecided
Related trials for Stroke
Not yet recruiting
Brain-Machine Interface With Virtual Reality and Neuromuscular Electrical Stimulation for Upper Limb Rehabilitation After Stroke
Ischemic Stroke
Recruiting
Understanding and Enhancing Human Health and Movement
Spinal Cord Injury, Stroke (CVA) or Transient Ischemic Attack
Not yet recruitingObservational study
Detecting and Predicting Post-stroke Cognitive Impairment Using the Oxford Cognitive Screen
Stroke, Ischemic Stroke
Not yet recruitingObservational study
Integrating Wearable Monitoring and Clinical Data for Stroke Early Warning
Stroke, Ischemic Stroke
RecruitingObservational study
Stroke Hemiplegic Shoulder Pain: Ultrasound Findings and VAS (Cross-Sectional)
Hemiplegic Shoulder Pain, Stroke
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.
Sofina Chan, MA contact
Jack Jiaqi Zhang principal investigator
The Hong Kong Polytechnic University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing digital mirror therapy and conventional mirror therapy in people with Stroke, run by The Hong Kong Polytechnic University at 2 sites in Hong Kong.
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 3 inclusion and 4 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: looking for participants now, as of the sponsor's last update on 10 Mar 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 Hong Kong. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jack Jiaqi Zhang, PhD (27666696, jack-jiaqi.zhang@polyu.edu.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fugl-Meyer Assessment Upper Extremity Scores (time frame: Baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 10 Mar 2026.