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

December 30, 2025 updated by: University of Lahore

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

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Actual)

52

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of Lahore Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mirror Therapy Group
Participants in this arm will receive mirror therapy, a rehabilitation technique where movements of the unaffected limb are reflected in a mirror to create a visual illusion that the affected limb is moving normally. Therapy sessions will be conducted [specify frequency, e.g., 30 minutes per day, 5 days a week] for [specify duration, e.g., 4 weeks].
Other: Mirror Therapy
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
Experimental: Routine Physical Therapy Group
Participants in this arm will receive standard physical therapy for CRPS, including exercises, stretching, and functional activities aimed at improving mobility, reducing pain, and enhancing limb function. Sessions will be conducted [specify frequency, e.g., 30 minutes per day, 5 days a week] for [specify duration, e.g., 4 weeks].
Other: Routine Physical Therapy
Standard physical therapy including stretching, strengthening, and functional exercises to improve mobility, reduce pain, and restore limb function in CRPS patients.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
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
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.
• 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
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.
Baseline: Before the start of the intervention • Interim assessments: Weekly during the 4-week intervention period • Final assessment: At the end of 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Lahore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 24, 2024

Primary Completion (Actual)

May 4, 2025

Study Completion (Actual)

October 10, 2025

Study Registration Dates

First Submitted

December 30, 2025

First Submitted That Met QC Criteria

December 30, 2025

First Posted (Estimated)

January 12, 2026

Study Record Updates

Last Update Posted (Estimated)

January 12, 2026

Last Update Submitted That Met QC Criteria

December 30, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 70146229@student.uol.edu.pk

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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