Impact of Mirror Therapy Combined With Conventional Training on Gait and Lower Limb Motor Function Among Post-Stroke Patients

August 28, 2026 updated by: Ibadat International University, Islamabad
This randomized controlled trial aims to evaluate the effects of mirror therapy combined with conventional training on gait and lower limb motor function among post-stroke patients. Stroke remains a worldwide health crisis, persistently ranking as a leading cause of long-term severe disability. The study will evaluate the gait and lower limb motor function.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

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 Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Balochistan
      • Quetta, Balochistan, Pakistan
        • Recruiting
        • Department of Physical Therapy at suleman medical complex hospital, Quetta.
        • Contact:

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:

  • Diagnosed with the first-ever unilateral stroke.
  • Duration of stroke between 3 months and 6 months (subacute to chronic stage).
  • Both male and female patients aged 40 to 70 years.
  • Ability to walk at least 10 meters independently.
  • Mini Mental State Examination (MMSE) score >24.
  • Brunnstrom stage of recovery for the lower limb is > 3, indicating some voluntary movement out of synergy.

Exclusion Criteria:

  • Severe cognitive impairment, perceptual deficits, or inability to follow simple verbal commands (e.g., severe aphasia or low MMSE score).
  • Presence of other neurological disorders affecting motor performance such as Parkinson's disease, multiple sclerosis, traumatic brain injury, or cerebellar disorders.
  • Severe musculoskeletal disorders of the lower limb, including fracture, contracture, severe osteoarthritis, or pain limiting participation in exercise.
  • Uncontrolled medical conditions such as unstable hypertension, uncontrolled diabetes mellitus, a recent cardiac event, or other conditions making exercise unsafe.
  • Severe visual impairment, vestibular dysfunction, or hearing loss that may interfere with treatment instructions or mirror-based feedback.
  • Severe unilateral neglect (hemispatial neglect) or apraxia interfering with task performance.
  • Current participation in another physiotherapy, rehabilitation, or interventional research study during the data collection period.

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: Group A
Participants in this group will receive mirror therapy-based functional training with conventional lower limb training. This training program will focus on gait and lower limb motor function.
Other: Mirror Therapy Based Functional Training

(Basic) - Sitting position:

  • Ankle dorsiflexion/plantarflexion (simulating pressing a gas pedal)
  • Knee extension/flexion (simulating kicking a ball)
  • Hip flexion/extension (simulating marching)
  • Ankle circling in both directions (Intermediate)-Sitting to standing transition:
  • Performing "stepping" movements while seated
  • Simulated sit-to-stand movements focusing on weight transfer observed in the reflection
  • Sliding the foot forward and backward along the floor (simulating the swing phase of gait)
  • Heel slides (Advanced) - Standing position:
  • Heel raises and toe raises in standing
  • Weight shifting between limbs observing symmetry in the mirror
  • Mini squats and half squats with mirror feedback
  • Stepping forward, backward, and laterally
  • Tracing shapes or following a moving target with the foot
  • Practicing coordinated ankle movements essential for navigating uneven terrain.
Other: Conventional Lower Limb Training

Passive and active-assisted range of motion exercises for hip, knee, and ankle joints of the affected limb

  • Bridging exercises
  • Ankle dorsiflexion/plantarflexion against manual resistance or TheraBand
  • Seated knee extension
  • Mini squats
  • Heel raises
  • Straight leg raises
  • Weight shifting in standing (side-to-side and front-toback)
  • Sit-to-stand transfers
  • Tandem standing
  • Single-leg stance (with support as needed)
  • Standing on foam surface (if available)
  • Practice walking on level surfaces with emphasis on weight-bearing on affected limb
  • Focus on heel strike and push-off phases
  • Verbal cues for step length and symmetry
  • Gait speed variations (slow to moderate pace)
  • Gentle stretching of hamstrings, quadriceps, gastrocnemius, and soleus muscles
Active Comparator: Group B
Participants in this group will receive conventional lower limb training. This training program will focus on gait and lower limb motor function.
Other: Conventional Lower Limb Training

Passive and active-assisted range of motion exercises for hip, knee, and ankle joints of the affected limb

  • Bridging exercises
  • Ankle dorsiflexion/plantarflexion against manual resistance or TheraBand
  • Seated knee extension
  • Mini squats
  • Heel raises
  • Straight leg raises
  • Weight shifting in standing (side-to-side and front-toback)
  • Sit-to-stand transfers
  • Tandem standing
  • Single-leg stance (with support as needed)
  • Standing on foam surface (if available)
  • Practice walking on level surfaces with emphasis on weight-bearing on affected limb
  • Focus on heel strike and push-off phases
  • Verbal cues for step length and symmetry
  • Gait speed variations (slow to moderate pace)
  • Gentle stretching of hamstrings, quadriceps, gastrocnemius, and soleus muscles

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
10-Meter Walk Test (10MWT)
Time Frame: Baseline, Weeks 3 and 6.
This test measures gait speed (m/s) over a short distance and is a highly sensitive measure of functional walking ability. It has excellent test-retest reliability (ICC = 0.95 to 0.99) in individuals with chronic stroke and is considered a valid core outcome measure for gait recovery.
Baseline, Weeks 3 and 6.
Timed Up and Go Test (TUG)
Time Frame: Baseline, Weeks 3 and 6.
This test assesses functional mobility and dynamic balance by measuring the time (in seconds) it takes an individual to stand up from a chair, walk 3 meters, turn, walk back, and sit down. It demonstrates excellent reliability (ICC = 0.95) in the stroke population and is highly responsive to changes in mobility.
Baseline, Weeks 3 and 6.
Fugl-Meyer Assessment for Lower Extremity (FMA-LE)
Time Frame: Baseline, Weeks 3 and 6.
This is a stroke-specific performance-based impairment index used to quantitatively measure motor function, sensation, and coordination in the lower limb. It is widely regarded as the gold standard for assessing motor recovery after stroke, with high inter-rater reliability (ICC = 0.97).
Baseline, Weeks 3 and 6.
Wisconsin Gait Scale (WGS)
Time Frame: Baseline, Weeks 3 and 6.
This is a valid and reliable observational gait analysis tool specifically designed for the qualitative assessment of hemiplegic gait. It assesses 14 observable parameters across different phases of gait (e.g., stance, swing) and has high inter-rater (r = 0.91) and test-retest (r = 0.92) reliability in stroke patients (Rodriquez et al., 1996). The WGS was selected to capture the nuanced spatiotemporal improvements in gait pattern (e.g., step length, symmetry) that are clinically meaningful but may not be fully reflected in speed or timed tests alone.
Baseline, Weeks 3 and 6.

Collaborators and Investigators

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

Sponsor

Ibadat International University, Islamabad

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

  • GBD 2021 Stroke Collaborators. (2023). Global, regional, and national burden of stroke and its risk factors, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet Neurology, 22(10), 915-939. 2. Khan, M., Ahmed, S., & Anwar, S. (2022). Burden of stroke in Pakistan: A growing concern. Journal of Pakistan Medical Association, 72(2), 242-246. 3. Li, S., Francisco, G. E., & Zhou, P. (2018). Post-stroke hemiplegic gait: New perspective and insights. Physical Medicine and Rehabilitation Clinics of North America, 29(4), 719-735. 4. Hatem, S. M., Saussez, G., Della Faille, M., Prist, V., Zhang, X., Dispa, D., et al. (2016). Rehabilitation of motor function after stroke: A multiple systematic review focused on techniques to stimulate upper extremity recovery. Frontiers in Human Neuroscience, 10, 442. 5. Garrison, K. A., Winstein, C. J., & Aziz-Zadeh, L. (2010). The mirror neuron system: A neural substrate for methods in stroke rehabilitation. Neurorehabilitation and Neural Repair, 24(5), 404-412. 6. Thieme, H., Morkisch, N., Mehrholz, J., Pohl, M., Behrens, J., & Dohle, C. (2018). Mirror therapy for improving motor function after stroke. Cochrane Database of Systematic Reviews, 7, CD008449. 7. Broderick, P., Horgan, F., Blake, C., & O'Keeffe, M. (2022). Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Clinical Rehabilitation, 36(4), 437-453. 8. Veerbeek, J. M., van Wegen, E., van Peppen, R., van der Wees, P. J., Hendriks, E., Rietberg, M., et al. (2014). What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS ONE, 9(2), e87987. 9. Hornby, T. G., Reisman, D. S., Ward, I. G., Scheets, P. L., Miller, A., Haddad, D., et al. (2020). Clinical practice guideline to improve locomotor function following chronic stroke, incomplete spinal cord injury, and brain injury. Journal of Neurologic Physical Therapy, 44(1), 49-100.

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)

April 15, 2026

Primary Completion (Estimated)

September 20, 2026

Study Completion (Estimated)

September 25, 2026

Study Registration Dates

First Submitted

July 6, 2026

First Submitted That Met QC Criteria

August 28, 2026

First Posted (Actual)

September 1, 2026

Study Record Updates

Last Update Posted (Actual)

September 1, 2026

Last Update Submitted That Met QC Criteria

August 28, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IIUI/RERC/ADT/2026/05/260

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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