StrokeNCT07533734
The Effects of an Augmented Reality-Based Mirror Therapy System in Patients With Stroke
A study testing Augmented Reality-Based Mirror Therapy, Conventional Mirror Therapy and Conventional Physiotherapy Treatment in people with Stroke, run by Marmara University at 1 site in Turkey (Türkiye).
Trial summary
Objective The aim of this study is to investigate the effects of an augmented reality-based mirror therapy system (MirrARm), developed using sensor-based tracking and visual feedback principles, on upper extremity motor recovery and functional activity levels in patients with stroke. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Stroke
- What is being tested?
- Augmented Reality-Based Mirror Therapy, Conventional Mirror Therapy and Conventional Physiotherapy Treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jul 2026to 1 Aug 2027
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- First-ever unilateral stroke diagnosed by a specialist physician,
- Presence of post-stroke hemiplegia,
- Age ≥ 18 years,
- Time since stroke between 3 and 12 months,
- Score ≥ 24 on the Standardized Mini-Mental State Examination,
- Upper extremity motor score ≤ 22 on the Fugl-Meyer Assessment.
Who cannot join
- Inability to sit independently in a supported chair,
- Insufficient communication ability due to aphasia,
- Presence of structural and/or acquired impairments limiting active movement of the unaffected upper limb,
- Presence of visual or visual-perceptual impairments,
- Presence of unilateral neglect,
- Presence of neurological, psychiatric, cognitive, or oncological disorders other than stroke.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site
Acıbadem University Atakent Hospital
Istanbul, Küçükçekmece, 34303
Ceyhun BAŞOĞLU, Physician, MD, +90 507 955 4826, ceyhun.basoglu@acibadem.com
Sergen Öztürk, Msc.
About this study
Official title: The Effect of an Augmented Reality-Based Mirror Therapy System on Upper Extremity Motor Recovery and Functional Activity Level in Stroke Patients
Objective The aim of this study is to investigate the effects of an augmented reality-based mirror therapy system (MirrARm), developed using sensor-based tracking and visual feedback principles, on upper extremity motor recovery and functional activity levels in patients with stroke.
Research Questions
Read more
This study seeks to address the following questions:
Does the MirrARm system improve upper extremity motor recovery and functional activity levels in patients with stroke?
Are the effects of the MirrARm system on upper extremity motor recovery and functional activity levels greater than those of conventional mirror therapy in patients with stroke?
Study Design and Comparison The MirrARm system will be compared with conventional mirror therapy to evaluate its effectiveness in patients with stroke.
Participants and Procedures Participants will take part in a treatment program administered three days per week for a total duration of eight weeks. Outcome measures will be assessed at baseline (Week 0), at mid-intervention (Week 4), and at the end of the intervention period (Week 8).
Read the detailed description
The aim of this study is to develop an augmented reality-based mirror therapy system, MirrARm, based on sensor-based tracking and visual reflection principles, and to investigate its effects on upper extremity motor recovery and functional activity levels in patients with stroke.
In this study, individuals with stroke who meet the inclusion criteria will be randomly assigned into two groups using stratification based on age, sex, and Fugl-Meyer Upper Extremity scores. The groups will be the Augmented Reality-Based Mirror Therapy group (AR-MT) and the Conventional Mirror Therapy group (C-MT). All participants will receive conventional physiotherapy training for 30 minutes per session, three days per week, for eight weeks. Participants in the AR-MT group will additionally receive 30 minutes of exercise training using the MirrARm system three days per week for eight weeks, while participants in the C-MT group will receive exercise training using conventional mirror therapy for the same duration and frequency.
In this study, augmented reality-based mirror therapy training will be delivered using the MirrARm system. The MirrARm system will consist of a 27-inch computer monitor, a Leap Motion Controller motion-tracking sensor, and a laptop computer. The monitor will be placed on a work table and will display images transmitted from the connected laptop computer. The Leap Motion sensor will also be connected to the laptop computer and positioned on the table in front of the monitor. The Leap Motion sensor will be used to transfer participants' hand movements to the screen in real time. Through its software features, the MirrARm system will display movements performed with one hand on the screen as if they were being performed by the opposite hand.
The software infrastructure of the MirrARm system will be developed using the Unity 6.1 game engine. Participants' hand movements will be tracked with high precision in a three-dimensional environment using the official software development kits (SDKs) and libraries of the Leap Motion device. Applications will be designed using ready-made or customized Unity assets positioned within a three-dimensional coordinate system in the Unity environment, and realistic physical interactions will be provided through Unity's NVIDIA PhysX-based physics engine. The operation of the application will be controlled through custom MonoBehaviour-based scripts developed using the C# programming language. These scripts will dynamically manipulate Transform component properties of scene objects, including position, rotation, and scale; process user interactions through event-based triggers; and execute predefined functions within the game loop. Objects requiring physical interaction will be assigned Unity's Rigidbody component to provide physical properties such as mass, gravity, and collision responses, and interaction regions will be defined using Collider components.
During training sessions using the MirrARm system, participants with stroke will be seated in front of the screen on a back-supported chair and will perform the tasks included in gamified therapeutic activities using their unaffected upper limb, while observing these movements on the screen as if they were being performed by the affected upper limb.
Four different activities to be used in the MirrARm system have been designed by the researchers based on movements considered important for upper extremity functionality after stroke. Each activity has been designed with three levels of difficulty. Participants will perform each level for two minutes, with a 30-second rest period between levels. The task-oriented activities of the MirrARm system are as follows:
- Cube stacking activity (shoulder elevation-focused)
- Reaching activity (elbow extension-focused)
- Supination-pronation activity
- Horizontal ring activity (wrist extension-focused)
All participants included in the study will be assessed three times during the intervention period (Week 0, Week 4, and Week 8) using primary and secondary outcome measures by a blinded assessor.
All statistical analyses of the data obtained from participants will be performed using SPSS version 27.0 (IBM Corp., Armonk, NY, USA). Continuous variables will be reported as mean ± standard deviation when the assumption of normal distribution is met and as median (interquartile range) when it is not. Categorical variables will be reported as number (N) and percentage (%). Assumption checks will include the Shapiro-Wilk test for normality, Levene's test for homogeneity of variances, and Mauchly's test for sphericity; in cases of sphericity violation, the Greenhouse-Geisser correction will be applied. When assumptions are met, a two-way mixed-design (2×3) analysis of variance (ANOVA) will be conducted for each outcome measure. The main effects of time and group, as well as the time × group interaction, will be tested, and multiple comparisons will be performed using Bonferroni correction. Effect sizes will be reported as partial eta squared (η²p), with 95% confidence intervals and a significance level set at p = 0.05. When assumptions are not met, within-group changes across three time points will be analyzed using the Friedman test, followed by Bonferroni-corrected pairwise Wilcoxon tests if significant. Between-group comparisons will be performed using the Mann-Whitney U test based on change scores across time points. Nonparametric results will be reported with effect sizes, 95% confidence intervals, and a significance level of p = 0.05.
- Conditions
- Stroke
- Being tested
- Augmented Reality-Based Mirror Therapy, Conventional Mirror Therapy, Conventional Physiotherapy Treatment
- Keywords
- Augmented Reality, Mirror Movement Therapy, Stroke Rehabilitation
- Medical subject headings
- Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Augmented Reality-Based Mirror TherapyOther
The MirrARm system will consist of a 27-inch computer monitor placed on a work table, a Leap Motion Controller motion-tracking sensor, and a laptop computer. Task-oriented and activities will be developed using the Unity 6.1 game engine.
During training, participants will be seated in a chair with back support and participants' hand movements will be visually mirrored according to mirror therapy principles. Movements performed with the unaffected upper limb will be displayed on the screen as if they were being executed by the affected limb.
The MirrARm system will include four task-oriented activities such as: Cube stacking activity (Shoulder elevation-focused), Reaching activity (Elbow extension-focused), Supination-pronation activity, Door knocking activity (Wrist extension-focused). Each activity will consist of three progressively increasing difficulty levels. Participants will perform each level for two minutes, with a 30-second rest period between levels and between activities.
Conventional Mirror TherapyOther
In conventional mirror therapy training, participants will be seated on a back-supported chair at a table, with a mirror (60 cm × 50 cm) positioned vertically between the upper limbs, facing the unaffected arm. Task-oriented activities will be performed with the unaffected upper limb and observed in the mirror as if executed by the affected limb, in accordance with mirror therapy principles. The same activities used in the MirrARm system will be performed using real objects. Each activity level will be applied for two minutes, with 30-second rest periods, for a total duration of 30 minutes per session.
Conventional Physiotherapy TreatmentOther
Conventional physiotherapy treatment will include neurophysiological approaches based on strengthening, stretching, and coordination exercises for the affected upper limb, as well as neuromuscular electrical stimulation.
| Study group | Role | What they receive |
|---|---|---|
| Augmented Reality-Based Mirror Therapy Group | Experimental | Participants in this group will undergo an 8-week training program administered three days per week. Each session will consist of 30 minutes of augmented reality-based mirror therapy exercise training using the MirrARm system developed by the research team, followed by 30 minutes of conventional physiotherapy treatment. Receives: Other: Augmented Reality-Based Mirror Therapy; Other: Conventional Physiotherapy Treatment |
| Conventional Mirror Therapy Group | Active comparator | Participants in this group will undergo an 8-week training program administered three days per week. Each session will consist of 30 minutes of exercise training using a mirror box followed by 30 minutes of conventional physiotherapy treatment. Receives: Other: Conventional Mirror Therapy; Other: Conventional Physiotherapy Treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fugl-Meyer Assessment - Upper Extremity
The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based measure developed in Sweden by Fugl-Meyer and colleagues in 1975 to evaluate motor function, balance, sensation, and joint functioning in individuals after stroke. The upper extremity subscale (FM-UE) is widely regarded as the gold standard for assessing upper limb motor impairment and quantifying motor recovery following stroke.
Measured: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
Wolf Motor Function Test
The Wolf Motor Function Test (WMFT) is a standardized assessment developed to evaluate upper extremity motor function in individuals with moderate to severe motor impairment. The test was originally developed by Wolf and colleagues and later modified by Morris and colleagues. The modified version of the WMFT will be used in this study.
The WMFT consists of 17 tasks. For 15 tasks, data are collected in two domains: Functional ability and Performance time. The remaining two tasks assess upper extremity muscle strength and will not be included in the present study.
Measured: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
The Chedoke Arm and Hand Activity Inventory-9
The Chedoke Arm and Hand Activity Inventory (CAHAI) is a standardized assessment with detailed administration and scoring guidelines designed to evaluate functional performance of the upper extremity in individuals after stroke. Because the original version is time-consuming to administer, a shortened 9-item version (CAHAI-9) was developed. The CAHAI-9 will be used in this study to assess functional upper limb activity.
Measured: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
Secondary outcomes (2)
Motor Activity Log-28
The Motor Activity Log-28 (MAL-28) is a structured, self-reported assessment used to evaluate the amount of use and quality of movement of the affected upper limb during daily activities outside of therapy sessions. The scale consists of 28 items, each rated on a 6-point ordinal scale ranging from 0 to 5, where 0 indicates no use of the affected arm and 5 indicates use with the same frequency and quality as before the stroke.
Measured: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
Grip Strength
Grip strength of the affected upper limb will be measured using a hand dynamometer (SAEHAN Corporation, Korea; Model SH5001). Measurements will be performed with participants seated, feet flat on the floor, knees flexed at 90°, the arm positioned close to the body, elbow flexed at 90°, forearm in a neutral position, and wrist maintained in 0-30° of extension. Three consecutive measurements will be obtained, and the highest value will be recorded for analysis.
Measured: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Apr 2026
- Study start1 Jul 2026 (estimated)
- Primary completion1 Aug 2027 (estimated)
- Study completion1 Aug 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for StrokeStudies of the same condition, open and under way.
- More trials run by Marmara 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
- Model description
- The study is designed as a randomized controlled trial. For randomization, a computer-generated randomization table will be created using the website www.randomizer.org. To ensure balanced allocation between groups, stratification will be performed based on age (\<40 years, 40-65 years, \>65 years), sex (male/female), and Fugl-Meyer Upper Extremity score (\<10 and 10-22). Participants will be assigned to the study groups according to the order of enrollment in accordance with the randomization table.
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Marmara University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Burcu ERSÖZ HÜSEYİNSİNOĞLU, Professor, Principal investigator, Marmara University, Department of Physiotherapy and RehabilitationSergen ÖZTÜRK, PhD Student, Study director, Marmara University, Institute of Physiotherapy and Rehabilitation
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07533734
- Sponsor's protocol ID
- MU-FTR-PhD-2025/53-28
- Status last verified
- Apr 2026
- First submitted
- 9 Apr 2026
- Last updated
- 16 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011 Jul;40(4):423-9. doi: 10.1093/ageing/afr051. Epub 2011 May 30.
PubMed 21624928Ersoz Huseyinsinoglu, B., Ozdincler, A., Oğul, Ö., & Krespi, Y. (2011). Reliability And Validity Of Turkish Version Of Motor Activity Log-28. Turk Noroloji Dergisi, 17, 83-89.
Barreca SR, Stratford PW, Masters LM, Lambert CL, Griffiths J. Comparing 2 versions of the Chedoke Arm and Hand Activity Inventory with the Action Research Arm Test. Phys Ther. 2006 Feb;86(2):245-53.
PubMed 16445338Barreca S, Gowland CK, Stratford P, Huijbregts M, Griffiths J, Torresin W, Dunkley M, Miller P, Masters L. Development of the Chedoke Arm and Hand Activity Inventory: theoretical constructs, item generation, and selection. Top Stroke Rehabil. 2004 Fall;11(4):31-42. doi: 10.1310/JU8P-UVK6-68VW-CF3W.
PubMed 15592988Wolf SL, Lecraw DE, Barton LA, Jann BB. Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. Exp Neurol. 1989 May;104(2):125-32. doi: 10.1016/s0014-4886(89)80005-6.
PubMed 2707361Morris DM, Uswatte G, Crago JE, Cook EW 3rd, Taub E. The reliability of the wolf motor function test for assessing upper extremity function after stroke. Arch Phys Med Rehabil. 2001 Jun;82(6):750-5. doi: 10.1053/apmr.2001.23183.
PubMed 11387578Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.
PubMed 1135616Mekbib DB, Debeli DK, Zhang L, Fang S, Shao Y, Yang W, Han J, Jiang H, Zhu J, Zhao Z, Cheng R, Ye X, Zhang J, Xu D. A novel fully immersive virtual reality environment for upper extremity rehabilitation in patients with stroke. Ann N Y Acad Sci. 2021 Jun;1493(1):75-89. doi: 10.1111/nyas.14554. Epub 2021 Jan 14.
PubMed 33442915
Study at a glance
From the registry record, last updated by the sponsor on 16 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of an Augmented Reality-Based Mirror Therapy System on Upper Extremity Motor Recovery and Functional Activity Level in Stroke Patients
- ClinicalTrials.gov ID
- NCT07533734
- Acronym / sponsor ID
- MU-FTR-PhD-2025/53-28
- Conditions
- Stroke
- Keywords
- Augmented Reality, Mirror Movement Therapy, Stroke Rehabilitation
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Marmara UniversityUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 1 Aug 2027 (estimated)
- Study completion
- 1 Aug 2027 (estimated)
- First posted
- 16 Apr 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.
Objective The aim of this study is to investigate the effects of an augmented reality-based mirror therapy system (MirrARm), developed using sensor-based tracking and visual feedback principles, on upper extremity motor recovery and functional activity levels in patients with stroke.
Research Questions
This study seeks to address the following questions:
Does the MirrARm system improve upper extremity motor recovery and functional activity levels in patients with stroke?
Are the effects of the MirrARm system on upper extremity motor recovery and functional activity levels greater than those of conventional mirror therapy in patients with stroke?
Study Design and Comparison The MirrARm system will be compared with conventional mirror therapy to evaluate its effectiveness in patients with stroke.
Participants and Procedures Participants will take part in a treatment program administered three days per week for a total duration of eight weeks. Outcome measures will be assessed at baseline (Week 0), at mid-intervention (Week 4), and at the end of the intervention period (Week 8).
Detailed description
The aim of this study is to develop an augmented reality-based mirror therapy system, MirrARm, based on sensor-based tracking and visual reflection principles, and to investigate its effects on upper extremity motor recovery and functional activity levels in patients with stroke.
In this study, individuals with stroke who meet the inclusion criteria will be randomly assigned into two groups using stratification based on age, sex, and Fugl-Meyer Upper Extremity scores. The groups will be the Augmented Reality-Based Mirror Therapy group (AR-MT) and the Conventional Mirror Therapy group (C-MT). All participants will receive conventional physiotherapy training for 30 minutes per session, three days per week, for eight weeks. Participants in the AR-MT group will additionally receive 30 minutes of exercise training using the MirrARm system three days per week for eight weeks, while participants in the C-MT group will receive exercise training using conventional mirror therapy for the same duration and frequency.
In this study, augmented reality-based mirror therapy training will be delivered using the MirrARm system. The MirrARm system will consist of a 27-inch computer monitor, a Leap Motion Controller motion-tracking sensor, and a laptop computer. The monitor will be placed on a work table and will display images transmitted from the connected laptop computer. The Leap Motion sensor will also be connected to the laptop computer and positioned on the table in front of the monitor. The Leap Motion sensor will be used to transfer participants' hand movements to the screen in real time. Through its software features, the MirrARm system will display movements performed with one hand on the screen as if they were being performed by the opposite hand.
The software infrastructure of the MirrARm system will be developed using the Unity 6.1 game engine. Participants' hand movements will be tracked with high precision in a three-dimensional environment using the official software development kits (SDKs) and libraries of the Leap Motion device. Applications will be designed using ready-made or customized Unity assets positioned within a three-dimensional coordinate system in the Unity environment, and realistic physical interactions will be provided through Unity's NVIDIA PhysX-based physics engine. The operation of the application will be controlled through custom MonoBehaviour-based scripts developed using the C# programming language. These scripts will dynamically manipulate Transform component properties of scene objects, including position, rotation, and scale; process user interactions through event-based triggers; and execute predefined functions within the game loop. Objects requiring physical interaction will be assigned Unity's Rigidbody component to provide physical properties such as mass, gravity, and collision responses, and interaction regions will be defined using Collider components.
During training sessions using the MirrARm system, participants with stroke will be seated in front of the screen on a back-supported chair and will perform the tasks included in gamified therapeutic activities using their unaffected upper limb, while observing these movements on the screen as if they were being performed by the affected upper limb.
Four different activities to be used in the MirrARm system have been designed by the researchers based on movements considered important for upper extremity functionality after stroke. Each activity has been designed with three levels of difficulty. Participants will perform each level for two minutes, with a 30-second rest period between levels. The task-oriented activities of the MirrARm system are as follows:
- Cube stacking activity (shoulder elevation-focused)
- Reaching activity (elbow extension-focused)
- Supination-pronation activity
- Horizontal ring activity (wrist extension-focused)
All participants included in the study will be assessed three times during the intervention period (Week 0, Week 4, and Week 8) using primary and secondary outcome measures by a blinded assessor.
All statistical analyses of the data obtained from participants will be performed using SPSS version 27.0 (IBM Corp., Armonk, NY, USA). Continuous variables will be reported as mean ± standard deviation when the assumption of normal distribution is met and as median (interquartile range) when it is not. Categorical variables will be reported as number (N) and percentage (%). Assumption checks will include the Shapiro-Wilk test for normality, Levene's test for homogeneity of variances, and Mauchly's test for sphericity; in cases of sphericity violation, the Greenhouse-Geisser correction will be applied. When assumptions are met, a two-way mixed-design (2×3) analysis of variance (ANOVA) will be conducted for each outcome measure. The main effects of time and group, as well as the time × group interaction, will be tested, and multiple comparisons will be performed using Bonferroni correction. Effect sizes will be reported as partial eta squared (η²p), with 95% confidence intervals and a significance level set at p = 0.05. When assumptions are not met, within-group changes across three time points will be analyzed using the Friedman test, followed by Bonferroni-corrected pairwise Wilcoxon tests if significant. Between-group comparisons will be performed using the Mann-Whitney U test based on change scores across time points. Nonparametric results will be reported with effect sizes, 95% confidence intervals, and a significance level of p = 0.05.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- The study is designed as a randomized controlled trial. For randomization, a computer-generated randomization table will be created using the website www.randomizer.org. To ensure balanced allocation between groups, stratification will be performed based on age (<40 years, 40-65 years, >65 years), sex (male/female), and Fugl-Meyer Upper Extremity score (<10 and 10-22). Participants will be assigned to the study groups according to the order of enrollment in accordance with the randomization table.
| Arm | Type | Receives |
|---|---|---|
| Augmented Reality-Based Mirror Therapy Group | Experimental | Other: Augmented Reality-Based Mirror Therapy, Other: Conventional Physiotherapy TreatmentParticipants in this group will undergo an 8-week training program administered three days per week. Each session will consist of 30 minutes of augmented reality-based mirror therapy exercise training using the MirrARm system developed by the research team, followed by 30 minutes of conventional physiotherapy treatment. |
| Conventional Mirror Therapy Group | Active comparator | Other: Conventional Mirror Therapy, Other: Conventional Physiotherapy TreatmentParticipants in this group will undergo an 8-week training program administered three days per week. Each session will consist of 30 minutes of exercise training using a mirror box followed by 30 minutes of conventional physiotherapy treatment. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- First-ever unilateral stroke diagnosed by a specialist physician,
- Presence of post-stroke hemiplegia,
- Age ≥ 18 years,
- Time since stroke between 3 and 12 months,
- Score ≥ 24 on the Standardized Mini-Mental State Examination,
Key exclusion criteria (6 listed)
- Inability to sit independently in a supported chair,
- Insufficient communication ability due to aphasia,
- Presence of structural and/or acquired impairments limiting active movement of the unaffected upper limb,
- Presence of visual or visual-perceptual impairments,
- Presence of unilateral neglect,
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 |
|---|---|---|
| Augmented Reality-Based Mirror TherapyThe MirrARm system will consist of a 27-inch computer monitor placed on a work table, a Leap Motion Controller motion-tracking sensor, and a laptop computer. Task-oriented and activities will be developed using the Unity 6.1 game engine. During training, participants will be seated in a chair with back support and participants' hand movements will be visually mirrored according to mirror therapy principles. Movements performed with the unaffected upper limb will be displayed on the screen as if they were being executed by the affected limb. The MirrARm system will include four task-oriented activities such as: Cube stacking activity (Shoulder elevation-focused), Reaching activity (Elbow extension-focused), Supination-pronation activity, Door knocking activity (Wrist extension-focused). Each activity will consist of three progressively increasing difficulty levels. Participants will perform each level for two minutes, with a 30-second rest period between levels and between activities. | Other | Augmented Reality-Based Mirror Therapy Group |
| Conventional Mirror TherapyIn conventional mirror therapy training, participants will be seated on a back-supported chair at a table, with a mirror (60 cm × 50 cm) positioned vertically between the upper limbs, facing the unaffected arm. Task-oriented activities will be performed with the unaffected upper limb and observed in the mirror as if executed by the affected limb, in accordance with mirror therapy principles. The same activities used in the MirrARm system will be performed using real objects. Each activity level will be applied for two minutes, with 30-second rest periods, for a total duration of 30 minutes per session. | Other | Conventional Mirror Therapy Group |
| Conventional Physiotherapy TreatmentConventional physiotherapy treatment will include neurophysiological approaches based on strengthening, stretching, and coordination exercises for the affected upper limb, as well as neuromuscular electrical stimulation. | Other | Augmented Reality-Based Mirror Therapy Group, Conventional Mirror Therapy Group |
Primary outcome
Fugl-Meyer Assessment - Upper Extremity
Time frame: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based measure developed in Sweden by Fugl-Meyer and colleagues in 1975 to evaluate motor function, balance, sensation, and joint functioning in individuals after stroke. The upper extremity subscale (FM-UE) is widely regarded as the gold standard for assessing upper limb motor impairment and quantifying motor recovery following stroke.
Wolf Motor Function Test
Time frame: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
The Wolf Motor Function Test (WMFT) is a standardized assessment developed to evaluate upper extremity motor function in individuals with moderate to severe motor impairment. The test was originally developed by Wolf and colleagues and later modified by Morris and colleagues. The modified version of the WMFT will be used in this study. The WMFT consists of 17 tasks. For 15 tasks, data are collected in two domains: Functional ability and Performance time. The remaining two tasks assess upper extremity muscle strength and will not be included in the present study.
The Chedoke Arm and Hand Activity Inventory-9
Time frame: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
The Chedoke Arm and Hand Activity Inventory (CAHAI) is a standardized assessment with detailed administration and scoring guidelines designed to evaluate functional performance of the upper extremity in individuals after stroke. Because the original version is time-consuming to administer, a shortened 9-item version (CAHAI-9) was developed. The CAHAI-9 will be used in this study to assess functional upper limb activity.
2 secondary outcomes
Motor Activity Log-28
Time frame: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
Grip Strength
Time frame: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).
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 16 Apr 2026.
- Results publication: PubMed 21624928Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011 Jul;40(4):423-9. doi: 10.1093/ageing/afr051. Epub 2011 May 30.
- Results publicationErsoz Huseyinsinoglu, B., Ozdincler, A., Oğul, Ö., & Krespi, Y. (2011). Reliability And Validity Of Turkish Version Of Motor Activity Log-28. Turk Noroloji Dergisi, 17, 83-89.
- Results publication: PubMed 16445338Barreca SR, Stratford PW, Masters LM, Lambert CL, Griffiths J. Comparing 2 versions of the Chedoke Arm and Hand Activity Inventory with the Action Research Arm Test. Phys Ther. 2006 Feb;86(2):245-53.
- Results publication: PubMed 15592988Barreca S, Gowland CK, Stratford P, Huijbregts M, Griffiths J, Torresin W, Dunkley M, Miller P, Masters L. Development of the Chedoke Arm and Hand Activity Inventory: theoretical constructs, item generation, and selection. Top Stroke Rehabil. 2004 Fall;11(4):31-42. doi: 10.1310/JU8P-UVK6-68VW-CF3W.
- Results publication: PubMed 2707361Wolf SL, Lecraw DE, Barton LA, Jann BB. Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. Exp Neurol. 1989 May;104(2):125-32. doi: 10.1016/s0014-4886(89)80005-6.
- Results publication: PubMed 11387578Morris DM, Uswatte G, Crago JE, Cook EW 3rd, Taub E. The reliability of the wolf motor function test for assessing upper extremity function after stroke. Arch Phys Med Rehabil. 2001 Jun;82(6):750-5. doi: 10.1053/apmr.2001.23183.
- Results publication: PubMed 1135616Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.
- Results publication: PubMed 33442915Mekbib DB, Debeli DK, Zhang L, Fang S, Shao Y, Yang W, Han J, Jiang H, Zhu J, Zhao Z, Cheng R, Ye X, Zhang J, Xu D. A novel fully immersive virtual reality environment for upper extremity rehabilitation in patients with stroke. Ann N Y Acad Sci. 2021 Jun;1493(1):75-89. doi: 10.1111/nyas.14554. Epub 2021 Jan 14.
- 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.
Burcu ERSÖZ HÜSEYİNSİNOĞLU, Professor principal investigator
Marmara University, Department of Physiotherapy and Rehabilitation
Sergen ÖZTÜRK, PhD Student study director
Marmara University, Institute of Physiotherapy and Rehabilitation
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Augmented Reality-Based Mirror Therapy, Conventional Mirror Therapy and Conventional Physiotherapy Treatment in people with Stroke, run by Marmara University at 1 site 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 6 inclusion and 6 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: opening soon, as of the sponsor's last update on 16 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 1 site 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?
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 Sergen ÖZTÜRK, PhD Student (+90 555 408 3678, ptsergenozturk@gmail.com), 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 (time frame: Assessments will be conducted at three time points: at baseline (Week 0), mid-intervention (Week 4), and post-intervention (Week 8).). The study lists 3 primary outcomes in all. 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 NCT07533734, which also lists 8 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 16 Apr 2026; AzTrials last refreshed its copy on 2 Nov 2026.