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NCT Number: NCT07546864

Comparative Effects of Mirror Therapy and Cognitive Orientation to Daily Occupational Performance in Stroke: A 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.

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.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Stroke Rehabilitaion Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Bayburt State Hospital

Bayburt, Merkez, 69000, Turkey (Türkiye)

Location status: Recruiting

Location contact

NURTEN BİLGİN, PhD Student

CONTACT

[email protected]

05546366542

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • - 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

Exclusion criteria

  • - 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)

Treatment and study plan

Mirror Therapy

Behavioral

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)

Behavioral

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 therapy

Behavioral

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 Training

Other

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.

Primary outcomes

  1. 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.

Secondary outcomes

  1. Revised Nottingham Sensory Assessment (rNSA)

    Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up

    Used to assess somatosensory function including tactile sensation and proprioception.

  2. Canadian Occupational Performance Measure (COPM)

    Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up

    Used to assess Occupational Performance .

  3. Modified Barthel Index (MBI)

    Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up

    Used to assess activity daily of life

  4. Stroke Impact Scale (SIS)

    Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up

    Used to assess quality of life

  5. Stroke Self-Efficacy Questionnaire (SSEQ)

    Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up

    Used to assess self-efficacy

  6. Community Integration Questionnaire (CIQ)

    Time frame: Baseline, post-intervention (4 weeks), and 3-month follow-up

    Used to assess paticipation

Study contacts

Contact information is provided by the study sponsor or research team.

NURTEN BİLGİN, PhD Student

CONTACT

[email protected]

+905546366542

Sponsors and collaborators

Lead sponsor

Hacettepe University

Other

Registry information

Official study 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

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
Apr 23, 2026
Registry last updated
Apr 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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