Assessing the Priming Effects of Mirror Visual Feedback on Bilateral Task Practice in Patients with Stroke: A Quasi-Experimental Study

Background: Mirror visual feedback (MVF) is a technique used in stroke patients’ rehabilitation to improve their motor recovery. Bilateral arm training (BAT) has emerged as an approach that leads to positive outcomes in addressing upper extremity paresis after stroke. Objectives: The objective of this study was to assess the effects of visual priming with MVF on stroke patients’ ability to regain function. Study Design: This was a quasi-experimental study. Methods: Thirty patients (both males and females, aged 30–80 years) diagnosed with stroke having mild-to-moderate motor impairment based on Fugl-Meyer upper extremity scores between 18 and 55 were recruited in the study. Patients were selected based on convenient sampling. The experimental (mirror therapy + BAT) group ( n = 15) received bilateral task practice with MVF, whereas the control (BAT) group ( n = 15) received bilateral task practice without MVF. Intervention was delivered for 90 min a day, 3 days a week for 4 weeks. Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Chedoke Arm and Hand Activity Inventory (CAHAI), Motor Activity Log (MAL), and Stroke Impact Scale (SIS) were the outcome measures used. Results: The results indicate that both the experimental (mirror therapy + BAT) group and the control (BAT) group experienced significant improvements in most measured outcomes. For experimental (mirror therapy + BAT) group, FMA-UE ( P = 0.00, 95% confidence interval CI: −14.15, −6.90), CAHAI ( P = 0.001, 95% CI: −19.39, −6.60), MAL Amount of Use (AOU) ( P = 0.00, 95% CI: −1.69, −0.97), MAL Quality of Movement (QOM) ( P = 0.00, 95% CI: −1.41, −0.91), and SIS ( P = 0.00, 95% CI: −9.96, −7.36). For the control (BAT) group, FMA-UE ( P = 0.000, 95% CI: −14.15, −6.90), CAHAI ( P = 0.00, 95% CI: −19.39, −6.60), and MAL QOM ( P = 0.00, 95% CI: −1.14, −0.91) all showed significant improvements ( P < 0.05), indicating effective intervention. However, MAL AOU ( P = 0.111, 95% CI: −1.69, −0.97) did not show significant improvement, suggesting that while the control group (BAT) group improved overall, their perceived AOU of the affected limb did not change significantly. Mirror therapy in combination with BAT was found to be more effective compared to BAT alone. Conclusion: MVF appears to significantly enhance the efficacy of bilateral task practice in stroke patients, potentially offering a valuable tool for improving motor recovery. Trial registration: Clinical Trials Registry of India (CTRI), Registration Number (CTRI/2024/11/076332).