Combined Mirror Therapy and Soft Robotic Glove for Hand Recovery After Stroke

Stroke is one of the leading causes of long-term disability worldwide and commonly results in upper limb motor impairment. Recovery of hand function is essential for improving independence in activities of daily living. However, rehabilitation of the affected upper limb remains a major challenge in stroke management.

Mirror therapy is a rehabilitation technique that provides visual feedback by reflecting movements of the unaffected limb in a mirror, creating the illusion that the affected limb is moving normally. This approach is believed to promote cortical reorganization and enhance motor recovery. In recent years, robotic-assisted rehabilitation devices, including soft robotic gloves, have been developed to provide repetitive, task-specific training and facilitate motor relearning.

Soft robotic gloves are wearable assistive devices designed to support hand movements and enable repetitive practice of grasping and releasing tasks. These devices provide controlled assistance during rehabilitation exercises and may enhance the intensity and effectiveness of therapy.

This study is designed as a randomized controlled trial to evaluate the effectiveness of combining mirror therapy with soft robotic glove training in improving hand function among patients with post-stroke hemiplegia. Eligible participants will be randomly assigned to intervention groups receiving mirror therapy, soft robotic glove training, combined therapy, or conventional rehabilitation.

The intervention program will be delivered over a structured rehabilitation period, and clinical assessments will be conducted at baseline and after completion of the intervention. Outcome measures will focus on upper limb motor recovery, hand function performance, and functional independence.

The results of this study are expected to provide evidence regarding the effectiveness of integrating mirror therapy with robotic-assisted rehabilitation approaches for improving upper limb recovery after stroke. This may support the development of more effective rehabilitation protocols for patients with post-stroke hemiplegia.

Inclusion criteria

Adults aged 18-70 years with first-ever ischemic or hemorrhagic stroke confirmed by imaging (CT or MRI)

Moderate upper limb motor impairment (Fugl-Meyer Assessment Upper Extremity [FMA-UE] score 20-50)

Ability to follow simple instructions (Six-Item Cognitive Impairment Test, 6CIT)

Ability to sit independently for at least 30 minutes

Medically stable and cleared to participate in rehabilitation interventions

Willingness to provide informed consent and adhere to the study protocol

Exclusion criteria

Severe upper limb spasticity (Modified Ashworth Scale ≥ 3)

Cognitive or psychiatric disorders interfering with participation

Other neurological or musculoskeletal conditions affecting upper limb function (e.g., Parkinson's disease, multiple sclerosis, fractures)

Prior exposure to intensive Mirror Therapy or Soft Robotic Gloves

Visual impairment that cannot be corrected with glasses or contact lenses

Uncontrolled cardiovascular or other medical conditions that would prevent safe participation