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TerminatedNCT00643864Updated Apr 21, 2022Results posted

Mirror-Box Training in Adults With Chronic Hemiparesis Secondary to Stroke

An interventional study of mirror training in Stroke, sponsored by Wake Forest University Health Sciences. Terminated at 1 site in United States. Open to participants aged 30 Years to 80 Years. Per ClinicalTrials.gov, last updated 2022-04-21.

Sponsored by Wake Forest University Health Sciences · Not applicable, Interventional, and Treatment

Why this study was terminated
lack of enrollment
Phase
Not applicable
Study type
Interventional
Enrollment
3
Allocation
Not applicable
Ages
30 Years to 80 Years
Sex
All
01

Study summary

The purpose of this project is to assess the effects of four weeks of mirror-box training on weakness of one arm secondary to stroke. Primary measures are function and strength. Secondary measures will evaluate muscle tone, flexibility, and the subject's perception of their everyday function and improvement. Research Hypothesis: For chronic upper limb hemiparesis secondary to stroke, four weeks of mirror-box training with movement of the unaffected limb only results in a mean increase of 10 points on the Fugl-Meyer Test of Motor Recovery (Upper Extremity).

Read the detailed description

Due to the relatively new nature of mirror training, there are few randomized controlled studies. This pilot case series will serve as our initial step in trying to identify the frequency, duration, and treatment exercises needed in this population. Additionally, this pilot will allow us to ensure our outcome measures are appropriate to detect meaningful treatment changes. After obtaining informed consent, patients will undergo two separate baseline assessments of strength, function, and tone 4 weeks apart. Training sessions will consist of supervised activities using the unaffected arm while observing its mirror reflection; the affected arm will remain still. Sessions will be one hour a day, five days a week, for four weeks. Patients will be tested for strength, function and tone in the affected arm at completion of the four week treatment period by the same occupational therapist that performed the pretests.

02

Conditions studied

  • Stroke

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Keywords

  • mirror training
  • stroke
  • hemiparesis
  • rehabilitation
03

In context

Stroke

7,286 studies on the registry are indexed under Stroke; 2,007 are open to participants now.

This study's enrollment of 3 is below the median of 50 across 5,369 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Wake Forest University Health Sciences is the lead sponsor of 1,320 studies on the registry; 199 are open to participants now.

Of its 323 completed or terminated interventional studies of FDA-regulated products, 243 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • First unilateral ischemic stroke resulting in hemiparesis at least 6 months prior to enrollment.
  • Age at time of enrollment: 30-80 years.
  • Voluntary informed consent of patient.
  • Patient willing to comply with protocol and is available for all scheduled visits.
  • Residual upper extremity hemiparesis.
  • No changes in medications planned during 8-week participation.
  • No other motor rehabilitative therapy during 8-week participation, including E-stim and acupuncture.
  • At least 20 degrees of active wrist extension and 10 degrees of active finger extension against gravity in the affected upper limb, as measured by goniometry.

Exclusion criteria

Exclusion Criteria:

  • Serious cognitive deficits, as evidenced by score of \<20 on Modified Mini-Mental Status Exam
  • Hemorrhagic or bilateral strokes
  • Excessive spasticity at the elbow, wrist, or hand, defined as a Modified Ashworth Scale score of >2
  • History of botulinum toxin injection in affected upper extremity in the past 4 months
  • Lacking >40 degrees of passive elbow extension
  • Less than 45 degrees of passive shoulder flexion
  • Global or receptive aphasia present on physical exam
  • Hemispatial neglect present on physical exam
  • Patient participating in constraint-induced therapy during study time period
  • Severe visual deficits or visual field deficits as determined by ability to ascertain number of fingers held up on visual field testing
  • Deformity/amputation of unaffected upper limb
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
3 participants (actual)

Study arms

  • Other
    Mirror training

    Training will be performed one-on-one by an investigator in a quiet room, one hour a day, five days a week, for four weeks. The mirror-box apparatus consists of an 18" x 24" vertical mirror secured in the center of a wooden platform. During training, the mirror-box will be placed on a table in front of the subject so that the mirror is perpendicular to the chest, slightly lateral of midline. Subjects will be asked to attend to the mirror reflection of their unaffected hand performing a series of tasks, while keeping their affected limb still. At the end of the four week training period, posttests will be administered by the same therapist who performed the pretests.

    Behavioral: mirror training

Interventions

  • Behavioralmirror training

    Training will be performed one-on-one by an investigator in a quiet room, one hour a day, five days a week, for four weeks. Attendance will be recorded. The mirror-box apparatus consists of an 18" x 24" vertical mirror secured in the center of a wooden platform. During training, the mirror-box will be placed on a table in front of the subject so that the mirror is perpendicular to the chest, slightly lateral of midline. Subjects will be asked to attend to the mirror reflection of their unaffected hand performing a series of tasks, while keeping their affected limb still. At the end of the four week training period, posttests will be administered by the same Occupational Therapist who performed the pretests.

06

What researchers measure

Primary outcomes

  1. The Fugl-Meyer Assessment of Motor Function After Stroke

    The Fugl-Meyer Assessment of Motor Function After Stroke, a widely used scale of motor recovery after stroke. The subscale upper extremity motor function was used. This test requires progressively more complex movements and hand grasps and measure speed and coordination. Each item is graded on a 3-point ordinal scale (0=cannot perform; 1=partially performs; 2=performs fully) with a minimum score of 0 and a maximum score of 66 for the upper extremity. Higher scores indicate better outcome.

    Time frame: preintervention and post intervention

Secondary outcomes

  1. Arm Motor Ability Test

    The Arm Motor Ability Test evaluates disabilities in upper extremity function in activities of daily living using a quantitative and qualitative measure. The Functional Ability Scale and the Quality of Movement Scale are rated on an ordinal scale from 0-5. The score for the Functional Ability Scale ranges from 0 to 140. The score for the Quality of Movement Scale ranges from 0 to 140. Higher scores on the Functional Ability and Quality Scale of the Arm Motor Ability Test indicate more normal movement and a better outcome.

    Time frame: preintervention and post intervention

  2. Arm Motor Ability Test - Timed

    The time in seconds to complete 28 tasks is recorded. The tasks are: 1 pick up utensils, 2 cut meat, 3 fork to mouth, 4 pick up sandwich, 5 sandwich to mouth, 6 pick up spoon, 7 bean in spoon, 8 spoon to mouth, 9 grasp mug handle, 10 mug to mouth, 11pick up comb, 12 comb hair, 13 grasp jar top, 14 open jar, 15 tie lace, 16 phone to ear, 17 press phone number, 18 wipe up water, 19 throw away towel, 20 paretic arm in sleeve, 21 button two buttons, 22 arms in T-shirt, 23 shirt over head, 24 straighten shirt, 25 prop on extended arm, 26 turn on light, 27 open door, 28 close door. The total time in seconds to complete all 28 tasks is recorded - as a total summary score. There is no minimum value. There is no maximum value. Lower scores (e.g., less time to complete the 28 tasks) indicate faster performance and better outcome.

    Time frame: pre intervention and post intervention

07

Results

Posted Aug 5, 2019

Participant flow

Medical outpatient clinic

Pre-test Assessment
Participant flow — Pre-test Assessment
MilestoneMirror Training
Started3
Completed3
Not completed0
Post-test Assessment
Participant flow — Post-test Assessment
MilestoneMirror Training
Started3
Completed3
Not completed0

Outcome measures

PrimaryThe Fugl-Meyer Assessment of Motor Function After Stroke

The Fugl-Meyer Assessment of Motor Function After Stroke, a widely used scale of motor recovery after stroke. The subscale upper extremity motor function was used. This test requires progressively more complex movements and hand grasps and measure speed and coordination. Each item is graded on a 3-point ordinal scale (0=cannot perform; 1=partially performs; 2=performs fully) with a minimum score of 0 and a maximum score of 66 for the upper extremity. Higher scores indicate better outcome.

Time frame:
preintervention and post intervention
Reported as:
Mean · score on a scale
The Fugl-Meyer Assessment of Motor Function After Stroke
score on a scaleMirror Training
Fugl-Meyer Pre45.8 ± 12.6
Fugl-Meyer Post58 ± 0
SecondaryArm Motor Ability Test

The Arm Motor Ability Test evaluates disabilities in upper extremity function in activities of daily living using a quantitative and qualitative measure. The Functional Ability Scale and the Quality of Movement Scale are rated on an ordinal scale from 0-5. The score for the Functional Ability Scale ranges from 0 to 140. The score for the Quality of Movement Scale ranges from 0 to 140. Higher scores on the Functional Ability and Quality Scale of the Arm Motor Ability Test indicate more normal movement and a better outcome.

Time frame:
preintervention and post intervention
Reported as:
Mean · units on a scale
Arm Motor Ability Test
units on a scaleMirror Training
Functional Ability Pre92.8 ± 34.8
Quality Scale Pre90.1 ± 33.5
Functional Ability Post98.5 ± 53.0
Quality Scale Post94.5 ± 54.4
SecondaryArm Motor Ability Test - Timed

The time in seconds to complete 28 tasks is recorded. The tasks are: 1 pick up utensils, 2 cut meat, 3 fork to mouth, 4 pick up sandwich, 5 sandwich to mouth, 6 pick up spoon, 7 bean in spoon, 8 spoon to mouth, 9 grasp mug handle, 10 mug to mouth, 11pick up comb, 12 comb hair, 13 grasp jar top, 14 open jar, 15 tie lace, 16 phone to ear, 17 press phone number, 18 wipe up water, 19 throw away towel, 20 paretic arm in sleeve, 21 button two buttons, 22 arms in T-shirt, 23 shirt over head, 24 straighten shirt, 25 prop on extended arm, 26 turn on light, 27 open door, 28 close door. The total time in seconds to complete all 28 tasks is recorded - as a total summary score. There is no minimum value. There is no maximum value. Lower scores (e.g., less time to complete the 28 tasks) indicate faster performance and better outcome.

Time frame:
pre intervention and post intervention
Reported as:
Mean · seconds
Arm Motor Ability Test - Timed
secondsMirror Training
pre intervention330.7 ± 355.4
post intervention249.8 ± 257.2

Adverse events

Collected over 20 days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Mirror Training0/3 (0%)0/3 (0%)0/3 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Mirror Training
<=18 years0
Between 18 and 65 years3
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Mirror Training
Female2
Male1
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Mirror Training
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White2
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(Participants)Mirror Training
United States3
08

Study locations

1 site
  • Carolinas Rehabilitation
    Charlotte, North Carolina 28203, United States
09

References and documents

Related links

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 21, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00643864
Lead sponsor
Wake Forest University Health Sciences
Responsible party
Sponsor
First posted
Mar 26, 2008
Start date
Feb 2006
Primary completion
Feb 2012
Completion
Feb 2012
Results posted
Aug 5, 2019
Last update
Apr 21, 2022

Study contacts

Mark A Hirsch, PhD
principal investigator · CHS
Flora M Hammond, MD
study director · CHS

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.

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