StrokeNCT07546864
Comparative Effects of Mirror Therapy and Cognitive Orientation to Daily Occupational Performance in Stroke: A Randomized Controlled Trial
A study testing Mirror Therapy, Cognitive Orientation to Daily Occupational Performance (CO-OP) and Conventional Occupational Therapy in people with Stroke and Stroke Rehabilitaion, run by Hacettepe University at 1 site in Turkey (Türkiye).
Trial summary
This study aims to compare the effectiveness of three rehabilitation approaches in individuals with stroke: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Stroke, Stroke Rehabilitaion
- What is being tested?
- Mirror Therapy, Cognitive Orientation to Daily Occupational Performance (CO-OP) and Conventional Occupational Therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 45 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 15 Feb 2026to 15 Jun 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
- - Individuals diagnosed with ischemic or hemorrhagic stroke
- Age 18 years and older
- Subacute (3-6 months post-stroke) or chronic stage (6-12 months post-stroke)
- Brunnstrom Motor Recovery Stage ≥3 for upper extremity, ≥4 for hand, and ≥4 for lower extremity
- Mini-Mental State Examination (MMSE) score ≥24
- No severe visual, orthopedic, or additional neurological impairments
- Not participating in another study during the research period
- Voluntary consent to participate in the study
Who cannot join
- - Poor motor coordination or major medical problems that would prevent participation
- Presence of Wernicke's aphasia
- Botulinum toxin injection within the last 3 months
- Psychiatric conditions that may interfere with participation (e.g., depression, ongoing psychiatric treatment, low motivation)
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, 1 recruiting
- Recruiting
Bayburt State Hospital
Bayburt, Merkez, 69000
NURTEN BİLGİN, PhD Student, 05546366542, nurtenncek@gmail.com
About this study
Official title: Comparative Effects of Mirror Therapy, Cognitive Orientation to Daily Occupational Performance, and Conventional Occupational Therapy in Individuals With Stroke: A 3-Month Follow-Up Randomized Controlled Trial
This study aims to compare the effectiveness of three rehabilitation approaches in individuals with stroke: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training.
A total of 45 individuals with subacute and chronic stroke will be randomly assigned to one of three groups. Each group will receive 4 weeks of intervention (5 sessions per week), followed by a 3-month follow-up period.
Read more
Outcomes related to motor function, somatosensory function, activities of daily living, participation, and quality of life will be assessed at baseline, after intervention, and at follow-up.
The study aims to determine which intervention approach is more effective in improving functional outcomes in individuals with stroke.
Read the detailed description
Stroke is one of the leading causes of disability worldwide, often resulting in motor, sensory, and cognitive impairments. Rehabilitation approaches that enhance neuroplasticity are essential for improving functional recovery.
This randomized controlled trial aims to compare the effectiveness of mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training (RBT), in individuals with stroke.
Participants will be recruited from a physical therapy and rehabilitation unit and will be randomly assigned into three groups: MT, CO-OP, and COT. All groups will receive robotic balance training as a priming intervention prior to therapy sessions.
Each intervention will be administered for 4 weeks, 5 days per week. In addition, a transfer package will be applied to enhance the generalization of therapeutic gains to daily life activities.
Outcome measures will include motor function, somatosensory function, occupational performance, activities of daily living, participation, self-efficacy, and quality of life. Assessments will be conducted at baseline, post-intervention, and at a 3-month follow-up.
The findings of this study are expected to provide evidence for the comparative effectiveness of different rehabilitation approaches in stroke and contribute to clinical decision-making.
- Conditions
- Stroke, Stroke Rehabilitaion
- Being tested
- Mirror Therapy, Cognitive Orientation to Daily Occupational Performance (CO-OP), Conventional Occupational Therapy, Robotic Balance Training
- Keywords
- mirror therapy, Randomized Controlled Trial, Stroke, Cognitive Orientation to Daily Occupational Performance Occupational Therapy, somatosensory, participation, activity daily of life, occupational therapy
- Medical subject headings
- Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mirror TherapyBehavioural
Mirror therapy involves the use of a mirror to create a visual illusion of movement of the affected limb by observing the reflection of the unaffected limb. Task-oriented activities are performed to improve motor function and sensory integration in individuals with stroke.
Cognitive Orientation to Daily Occupational Performance (CO-OP)Behavioural
CO-OP is a client-centered, performance-based approach that uses cognitive strategies to enable skill acquisition. Participants identify meaningful goals and use guided discovery and problem-solving strategies to improve task performance.
Conventional Occupational TherapyBehavioural
Conventional occupational therapy includes task-oriented interventions such as reaching, grasping, coordination training, strengthening exercises, and activities aimed at improving functional independence in daily living.
Robotic Balance TrainingOther
Robotic balance training is used as a priming intervention before therapy sessions. It includes repetitive, task-specific movements involving weight shifting, postural control, and balance training to enhance motor responses.
| Study group | Role | What they receive |
|---|---|---|
| Mirror Therapy Group | Experimental | Participants in this group will receive mirror therapy combined with robotic balance training. Mirror therapy will be applied using task-oriented activities involving upper and lower extremities based on individual needs. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. Receives: Behavioral: Mirror Therapy; Other: Robotic Balance Training |
| CO-OP Group | Experimental | Participants in this group will receive cognitive orientation to daily occupational performance (CO-OP) combined with robotic balance training. Individualized goals will be determined and cognitive strategies will be used to improve task performance. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. Receives: Behavioral: Cognitive Orientation to Daily Occupational Performance (CO-OP); Other: Robotic Balance Training |
| Conventional Occupational Therapy Group | Active comparator | Participants in this group will receive conventional occupational therapy combined with robotic balance training. The intervention will include task-oriented activities such as reaching, grasping, coordination, and strengthening exercises. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. Receives: Behavioral: Conventional Occupational Therapy; Other: Robotic Balance Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fugl-Meyer Motor Assessment (FMA)
The Fugl-Meyer Assessment will be used to evaluate motor function in individuals with stroke. Higher scores indicate better motor function.
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Secondary outcomes (6)
Revised Nottingham Sensory Assessment (rNSA)
Used to assess somatosensory function including tactile sensation and proprioception.
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Canadian Occupational Performance Measure (COPM)
Used to assess Occupational Performance .
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Modified Barthel Index (MBI)
Used to assess activity daily of life
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Stroke Impact Scale (SIS)
Used to assess quality of life
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Stroke Self-Efficacy Questionnaire (SSEQ)
Used to assess self-efficacy
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Community Integration Questionnaire (CIQ)
Used to assess paticipation
Measured: Baseline, post-intervention (4 weeks), and 3-month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Apr 2026
- Study start15 Feb 2026
- Primary completion15 May 2026 (estimated)
- Study completion15 Jun 2027 (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 Hacettepe 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
- Participants will be randomly assigned to one of three parallel groups: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), or conventional occupational therapy (COT). All groups will receive robotic balance training prior to intervention sessions. Interventions will be applied for 4 weeks, followed by a 3-month follow-up.
- Masking
- None (open label)
- Enrolment
- 45 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hacettepe University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Gokcen Akyurek, Hacettepe University
- Investigators
- Gokcen Akyurek, Associate Professor, Principal investigator, Hacettepe University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07546864
- Sponsor's protocol ID
- MT_COOP_STROKE_2026_NB
- Status last verified
- Apr 2026
- First submitted
- 17 Apr 2026
- Last updated
- 23 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- 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 23 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Mirror Therapy, Cognitive Orientation to Daily Occupational Performance, and Conventional Occupational Therapy in Individuals With Stroke: A 3-Month Follow-Up Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07546864
- Acronym / sponsor ID
- MT_COOP_STROKE_2026_NB
- Conditions
- Stroke, Stroke Rehabilitaion
- Keywords
- mirror therapy, Randomized Controlled Trial, Stroke, Cognitive Orientation to Daily Occupational Performance Occupational Therapy, somatosensory, participation, activity daily of life, occupational therapy
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 45 participants (estimated)
- Lead sponsor
- Hacettepe UniversityUniversity, hospital or other
- Study start
- 15 Feb 2026 (actual)
- Primary completion
- 15 May 2026 (estimated)
- Study completion
- 15 Jun 2027 (estimated)
- First posted
- 23 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.
This study aims to compare the effectiveness of three rehabilitation approaches in individuals with stroke: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training.
A total of 45 individuals with subacute and chronic stroke will be randomly assigned to one of three groups. Each group will receive 4 weeks of intervention (5 sessions per week), followed by a 3-month follow-up period.
Outcomes related to motor function, somatosensory function, activities of daily living, participation, and quality of life will be assessed at baseline, after intervention, and at follow-up.
The study aims to determine which intervention approach is more effective in improving functional outcomes in individuals with stroke.
Detailed description
Stroke is one of the leading causes of disability worldwide, often resulting in motor, sensory, and cognitive impairments. Rehabilitation approaches that enhance neuroplasticity are essential for improving functional recovery.
This randomized controlled trial aims to compare the effectiveness of mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training (RBT), in individuals with stroke.
Participants will be recruited from a physical therapy and rehabilitation unit and will be randomly assigned into three groups: MT, CO-OP, and COT. All groups will receive robotic balance training as a priming intervention prior to therapy sessions.
Each intervention will be administered for 4 weeks, 5 days per week. In addition, a transfer package will be applied to enhance the generalization of therapeutic gains to daily life activities.
Outcome measures will include motor function, somatosensory function, occupational performance, activities of daily living, participation, self-efficacy, and quality of life. Assessments will be conducted at baseline, post-intervention, and at a 3-month follow-up.
The findings of this study are expected to provide evidence for the comparative effectiveness of different rehabilitation approaches in stroke and contribute to clinical decision-making.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Participants will be randomly assigned to one of three parallel groups: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), or conventional occupational therapy (COT). All groups will receive robotic balance training prior to intervention sessions. Interventions will be applied for 4 weeks, followed by a 3-month follow-up.
| Arm | Type | Receives |
|---|---|---|
| Mirror Therapy Group | Experimental | Behavioral: Mirror Therapy, Other: Robotic Balance TrainingParticipants in this group will receive mirror therapy combined with robotic balance training. Mirror therapy will be applied using task-oriented activities involving upper and lower extremities based on individual needs. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. |
| CO-OP Group | Experimental | Behavioral: Cognitive Orientation to Daily Occupational Performance (CO-OP), Other: Robotic Balance TrainingParticipants in this group will receive cognitive orientation to daily occupational performance (CO-OP) combined with robotic balance training. Individualized goals will be determined and cognitive strategies will be used to improve task performance. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. |
| Conventional Occupational Therapy Group | Active comparator | Behavioral: Conventional Occupational Therapy, Other: Robotic Balance TrainingParticipants in this group will receive conventional occupational therapy combined with robotic balance training. The intervention will include task-oriented activities such as reaching, grasping, coordination, and strengthening exercises. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- - Individuals diagnosed with ischemic or hemorrhagic stroke
- Age 18 years and older
- Subacute (3-6 months post-stroke) or chronic stage (6-12 months post-stroke)
- Brunnstrom Motor Recovery Stage ≥3 for upper extremity, ≥4 for hand, and ≥4 for lower extremity
- Mini-Mental State Examination (MMSE) score ≥24
Key exclusion criteria (4 listed)
- - Poor motor coordination or major medical problems that would prevent participation
- Presence of Wernicke's aphasia
- Botulinum toxin injection within the last 3 months
- Psychiatric conditions that may interfere with participation (e.g., depression, ongoing psychiatric treatment, low motivation)
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 |
|---|---|---|
| Mirror TherapyMirror therapy involves the use of a mirror to create a visual illusion of movement of the affected limb by observing the reflection of the unaffected limb. Task-oriented activities are performed to improve motor function and sensory integration in individuals with stroke. | Behavioural | Mirror Therapy Group |
| Cognitive Orientation to Daily Occupational Performance (CO-OP)CO-OP is a client-centered, performance-based approach that uses cognitive strategies to enable skill acquisition. Participants identify meaningful goals and use guided discovery and problem-solving strategies to improve task performance. | Behavioural | CO-OP Group |
| Conventional Occupational TherapyConventional occupational therapy includes task-oriented interventions such as reaching, grasping, coordination training, strengthening exercises, and activities aimed at improving functional independence in daily living. | Behavioural | Conventional Occupational Therapy Group |
| Robotic Balance TrainingRobotic balance training is used as a priming intervention before therapy sessions. It includes repetitive, task-specific movements involving weight shifting, postural control, and balance training to enhance motor responses. | Other | CO-OP Group, Conventional Occupational Therapy Group, Mirror Therapy Group |
Primary outcome
Fugl-Meyer Motor Assessment (FMA)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
The Fugl-Meyer Assessment will be used to evaluate motor function in individuals with stroke. Higher scores indicate better motor function.
6 secondary outcomes
Revised Nottingham Sensory Assessment (rNSA)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
Canadian Occupational Performance Measure (COPM)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
Modified Barthel Index (MBI)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
Stroke Impact Scale (SIS)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
Stroke Self-Efficacy Questionnaire (SSEQ)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
Community Integration Questionnaire (CIQ)
Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up
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 23 Apr 2026.
- Individual participant dataSharing planned: Undecided
Related trials for Stroke
Not yet recruiting
Temporal Interference Stimulation for Upper-Limb Motor Recovery in Early Subacute Stroke
Acute Ischemic Stroke
RecruitingObservational study
ELATE Study: Evaluating Large-vessel Acute Thrombectomy in Extended Time Window
Acute Ichemic Stroke
Recruiting
Web-Based Tele-Rehabilitation Using Action Observation and Mirror Therapy for Subacute Stroke: A Randomized Controlled Trial
Stroke, Upper Extremity Paresis
Recruiting
Early Motor-Cognitive Integrative Training on Cognitive and Motor Performance in Patients With Aneurysmal Subarachnoid Hemorrhage
Subarachnoid Aneurysm Hemorrhage
Not yet recruiting
Selective Intra-Arterial Hypothermia After Endovascular Treatment for Acute Basilar Artery Occlusion
Acute Ischemic Stroke, Basilar Artery Occlusion
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.
Gokcen Akyurek, Associate Professor principal investigator
Hacettepe University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mirror Therapy, Cognitive Orientation to Daily Occupational Performance (CO-OP) and Conventional Occupational Therapy in people with Stroke and Stroke Rehabilitaion, run by Hacettepe 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 8 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 23 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 NURTEN BİLGİN, PhD Student (+905546366542, nurtenncek@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fugl-Meyer Motor Assessment (FMA) (time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up). 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 23 Apr 2026.