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NCT Number: NCT07332884

Comparative Effects of Mirror Therapy and Standard Physiotherapy in Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition characterized by persistent pain, sensory disturbances, motor dysfunction, and functional impairment, often following trauma or surgery. Conventional physical therapy is commonly used in the management of CRPS; however, treatment outcomes are often variable and incomplete. Mirror therapy is a non-invasive rehabilitation technique that uses visual feedback to influence cortical reorganization and may help reduce pain and improve motor function in patients with CRPS.

The purpose of this study is to compare the effectiveness of mirror therapy with routine physical therapy in patients diagnosed with Complex Regional Pain Syndrome. Eligible participants will be allocated into two groups. One group will receive mirror therapy in addition to standard rehabilitation exercises, while the control group will receive routine physical therapy alone. Both interventions will be delivered over a defined treatment period under supervised conditions.

Primary outcomes will include changes in pain intensity, while secondary outcomes will assess functional ability, range of motion, and overall limb use. Outcomes will be measured at baseline and after completion of the intervention period. This study aims to determine whether mirror therapy provides additional benefits over routine physical therapy in reducing pain and improving functional outcomes in patients with Complex Regional Pain Syndrome.

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Key information

Conditions

Complex Regional Pain Syndrome Agnosia Autonomic Nervous System Diseases Complex Regional Pain Syndromes Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Neuromuscular Diseases Pathological Conditions, Signs and Symptoms Perceptual Disorders Peripheral Nervous System Diseases Signs and Symptoms

Age range

40 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Lahore teaching hospital

Lahore, Punjab Province, 54000, Pakistan

About this study

Complex Regional Pain Syndrome (CRPS) is a disabling chronic pain condition that may develop after injury, surgery, or immobilization and is associated with disproportionate pain, sensory abnormalities, motor dysfunction, and reduced use of the affected limb. These impairments significantly affect daily activities and quality of life. Although routine physical therapy remains a cornerstone of CRPS management, optimal rehabilitation strategies continue to be explored.

Mirror therapy is a neurorehabilitation technique that provides visual feedback of the unaffected limb to create the illusion of normal movement in the affected limb. This approach is believed to modulate central nervous system processing, reduce maladaptive cortical reorganization, and improve motor control. Previous studies have suggested potential benefits of mirror therapy in chronic pain conditions; however, evidence comparing mirror therapy with routine physical therapy in CRPS remains limited.

This study is designed to evaluate and compare the effects of mirror therapy and routine physical therapy on pain and functional outcomes in patients diagnosed with Complex Regional Pain Syndrome. Participants will be assigned to one of two intervention groups. The experimental group will receive mirror therapy sessions alongside conventional rehabilitation exercises, while the control group will receive routine physical therapy based on standard clinical practice. Interventions will be administered by qualified physical therapists according to a predefined treatment protocol.

Outcome assessments will be conducted at baseline and at the end of the intervention period using standardized and validated measures. The study will assess changes in pain intensity, functional performance, and limb use to determine the comparative effectiveness of mirror therapy versus routine physical therapy. Findings from this study may contribute to evidence-based rehabilitation strategies for patients with Complex Regional Pain Syndrome.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age 40-65 years
  • Both genders
  • Hemiplegic patients with subacute stage
  • Patients who developed CRPS of the hand due to stroke
  • Patients with a diagnosis of CRPS 1

Exclusion criteria

Cognitive disorders and perceptual disorders

  • Comorbid conditions (e.g., decompensated heart failure, chronic renal insufficiency
  • Hand arthritis
  • Arterial/venous injuries and/ or undergoing arterial revascularization

Treatment and study plan

Mirror Therapy

Other

Participants perform movements with the unaffected limb while watching its reflection in a mirror, creating the visual illusion that the affected limb is moving normally. Aimed at reducing pain and improving motor functio

Routine physical therapy

Other

Standard physical therapy including stretching, strengthening, and functional exercises to improve mobility, reduce pain, and restore limb function in CRPS patients.

Primary outcomes

  1. Pain management

    Time frame: Duration of intervention: 4 weeks Frequency: 30 minutes per session, 5 sessions per week Pain assessments will be conducted at baseline (pre-intervention), weekly during the intervention, and at the end of 4 weeks to evaluate changes in pain intensity

    Participants in both arms will receive interventions aimed at reducing pain associated with Complex Regional Pain Syndrome. For the Mirror Therapy Group, pain reduction is targeted through visual-motor feedback, which can help retrain the brain and reduce pain perception. For the Routine Physical Therapy Group, pain is managed through exercises, stretching, and functional activities that improve mobility, reduce stiffness, and decrease pain intensity.

  2. Hand Grip

    Time frame: • Baseline assessment: Before the start of the intervention • Interim assessments: Weekly during the 4-week intervention period • Final assessment: At the end of 4 weeks

    Hand grip strength will be measured using a dynamometer to assess the functional strength of the affected limb in patients with Complex Regional Pain Syndrome. Participants will be instructed to squeeze the dynamometer maximally for a few seconds, and the best of three trials will be recorded for accuracy. This measurement evaluates improvements in motor function and muscle strength as a result of the intervention.

  3. spasticity

    Time frame: Baseline: Before the start of the intervention • Interim assessments: Weekly during the 4-week intervention period • Final assessment: At the end of 4 weeks

    Spasticity of the affected limb will be assessed using the Modified Ashworth Scale (MAS), which grades muscle tone from 0 (no increase in tone) to 4 (rigid in flexion or extension). The assessment evaluates resistance to passive movement, helping to determine changes in muscle stiffness and motor control resulting from the intervention.

Sponsors and collaborators

Lead sponsor

University of Lahore

Other

Registry information

Official study title

Comparison of Mirror Therapy and Routine Physical Therapy for the Management of Pain, Spasticity, and Strength in Patients With Complex Regional Pain Syndrome (CRPS): A Randomized Clinical Trial

Acronym: (CRPS)

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Jan 12, 2026
Registry last updated
Jan 12, 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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