Comparative Effects of Mirror Therapy, Proprioceptive Neuromuscular Facilitation, and Constraint-Induced Movement Therapy on Upper Limb Motor Recovery in Stroke Survivors: A Three-Arm Randomized Controlled Trial

This study aimed to compare the effects of these three interventions on upper limb motor recovery in stroke survivors.

A three-arm randomized controlled trial was conducted in which eligible participants (N=90) with post-stroke upper limb hemiparesis were randomly allocated into three groups of 30 each: MT group, PNF group, and CIMT group. All groups received their respective interventions alongside conventional physiotherapy, five sessions per week for six weeks.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Other: mirror therapy; Other: PNF; Other: Constraint-induced movement therapy

Detailed Description

Stroke remains a leading cause of long-term disability worldwide, with upper limb motor impairment being one of the most prevalent and debilitating consequences. While several neurorehabilitation approaches have demonstrated efficacy individually, limited evidence existed comparing the relative effectiveness of mirror therapy (MT), proprioceptive neuromuscular facilitation (PNF), and constraint-induced movement therapy (CIMT) within a single trial framework. This study aimed to compare the effects of these three interventions on upper limb motor recovery in stroke survivors.

A three-arm randomized controlled trial was conducted in which eligible participants (N=90) with post-stroke upper limb hemiparesis were randomly allocated into three groups of 30 each: MT group, PNF group, and CIMT group. All groups received their respective interventions alongside conventional physiotherapy, five sessions per week for six weeks. The outcome measure were the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Modified Ashworth Scale (MAS) and grip strength via hand-held dynamometry. Assessments were performed at baseline and at after 12 weeks post-intervention.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Gujrat, Punjab Province, Pakistan
      • Ikram Hospital, Gujrat

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Stroke Patients Both male and female Age: 25-65 years -

Exclusion Criteria:

unable to perform exercises Do not provide consent Cognitive Impairment

-

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Mirror Therapy	Other: mirror therapy; Mirror Therapy: Participant in the group were provided mirror therapy for a duration of 12 weeks
Active Comparator: Proprioceptive Neuromuscular Facilitation	Other: PNF; PNF Group: Participant were given PNF therapy for a total duration of 12 weeks
Active Comparator: Constraint-Induced Movement Therapy	Other: Constraint-induced movement therapy; Constraint-induced movement therapy: Participant were given Constraint-induced movement therapy for a total duration of 12 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Action Research Arm Test	The assessment were taken at baseline and after 12 weeks of intervention	12 weeks
Fugl-Meyer Assessment for Upper Extremity	The assessment were taken at baseline and after 12 weeks of intervention	12 weeks
Modified Ashworth Scale	The assessment were taken at baseline and after 12 weeks of intervention	12 weeks
grip strength via hand-held dynamometry	The assessment were taken at baseline and after 12 weeks of intervention	12 weeks

Collaborators and Investigators

• Sponsor: Foundation of Medical Research and Laboratories, Pakistan

Study record dates

Study Major Dates

• Study Start (Actual): July 3, 2025
• Primary Completion (Actual): January 3, 2026
• Study Completion (Actual): January 3, 2026

Study Registration Dates

• First Submitted: June 27, 2026
• First Submitted That Met QC Criteria: June 27, 2026
• First Posted (Actual): July 6, 2026

Study Record Updates

• Last Update Posted (Actual): July 6, 2026
• Last Update Submitted That Met QC Criteria: June 27, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Stroke, Mirror Therapy, Rehabilitation
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke; Therapeutics; Physical Therapy Modalities; Exercise Therapy; Rehabilitation; Mirror Movement Therapy; Constraint Induced Movement Therapy
• Other Study ID Numbers: FMRL_02_26

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