The Effect Of Exercises To Improve Balance Using Mirror As A Feedback In Stroke Patients- Pilot Study.


  • Arijit Kumar Das Associate Professor



Context: Though little attention has focused on the use of mirror therapy intervention on lower extremities post-stroke. The potential use of visual feedback is review in this study, focusing on mirror visual feedback and was performed for two specific reasons, one is for development of exercise for improving stroke patient's muscle power, balance and gait after verifying the result of the exercise, other is by applying this exercise into clinical trial was useful on hemiplegic stroke patients.

Method: Patients with stroke were screened at baseline and post intervention (after 2 weeks) balance was assessed by using Berg Balance Scale (BBS). Exercises were given for 5 days /week for 2 weeks.

Results: The results of the paired t test shows the comparison between the pre and post BBS was extremely significant (p value=0.0005)

Conclusion: Thus  we  conclude  that  using mirror as  a  feedback for lower limbs can  improve  balance  in  stroke  patients.


Author Biography

Arijit Kumar Das, Associate Professor

Associate Professor, Department of Cardiovascular and Respiratory Sciences, D.V.V.P.F’s College of Physiotherapy, Ahmednagar.


gait, stroke, mirror, exercise, balance


V. L. Feigin, M. H. Forouzanfar, R. Krishnamurthi et al., “Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010,” The Lancet, vol. 383, no. 9913, pp. 245–254, 2014.

Nichols M, Townsend N, Luengo-Fernandez R, et al., 2012, Royal College of Physicians National Sentinel, 2011, Stroke Clinical Audit 2010, Round 7, Public report for England, Wales and Northern Ireland, p. 43

Ikai T, Kamikubo T, Takehara I, et al.: Dynamic postural control in patients with hemiparesis. Am J Phys Med Rehabil, 2003, 82: 463–469, quiz 470–472, 484.

Carr JH, Shepherd RB, Nordholm L, et al.: Investigation of a new motor assessment scale for stroke patients. Phys Ther, 1985, 65: 175–180.

Eng JJ, Chu KS: Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil

Thielman G, Kaminski T, Gentile AM: Rehabilitation of reaching after stroke: comparing 2 training protocols utilizing trunk restraint. Neurorehabil Neural Repair, 2008, 22: 697–705.

Moreland JD, Goldsmith CH, Huijbregts MP, et al.: Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. Arch Phys Med Rehabil, 2003, 84: 1433–1440.

Woodson AM: Stroke. In: Radomski MV, Trombly Latham CA (Eds.), Occupational Therapy for Physical Dysfunction, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2008, pp 1001–1041.

Harris JE, Eng JJ, Marigold DS, Tokuno CD, Louis CL. Relationship of balance and mobility to fall incidence in people with chronic stroke. Phys Ther. 2005; 85(2):150–58.

Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87(4):554–61.

Chen IC, Cheng PT, Hu AL, Liaw MY, Chen LR, Hong WH, Wong MK. Balance evaluation in hemiplegic stroke patients. Chan Gung Med J. 2000;23(6):339–47.

Podsiadlo D, Richardson S. The timed “Up & Go:” A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–48.

Sanford J, Moreland J, Swanson LR, Stratford PW, Gowland C. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther. 1993;73(7):447–54.

Benaim C, Pérennou DA, Villy J, Rousseaux M, Pelissier JY. Validation of a standardized assessment of postural control in stroke patients: The Postural Assessment Scale for Stroke Patients (PASS). Stroke. 1999;30(9):1862–68.

S. S. Ng, and R. B. Shepherd, "Weakness in patients with stroke: implications for strength training in neurorehabilitation," Physical Therapy Reviews, vol. 5, no. 4, Dec. 2000, pp.227-238.

S. Nadeau, D. Gravel, and A. B. Arsenault, "Dynamometric assessment of the plantarflexion in hemiparetic subjects: relations between musculae, gait and clinical parameters," Scandinavian Journal of Rehabilitation Medicine, vol. 29, no. 3, Sep. 1997, pp.137-146.

K. Suzuki, G. Imada, and T. Iwaya, "Determinants and predictors of the maximum walking speed during computer-assisted gait training in hemiparetic stroke patients", Archives of Physical Medicine and Rehabilitation, vol. 80, no. 2, Feb. 1999, pp.179-182.

J. Perry, "The mechanics of walking in hemiplegia", Clinical Orthopaedics and Related Research, vol. 63, Mar-Apr. 1969, pp. 23-39.

J, J. Eng, and K. S. Chu, "Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke," Archives of Physical Medicine and Rehabilitation, vol. 83, no. 8, Aug. 2002, pp.1138-1144.

R. Dickstein, Z. Dvir, A. B. Jehosua, M. Rois, and T. Pillar, "Automatic and voluntary lateral shifts in Rehabilitation, vol. 8, no. 2, May. 1994, pp.91-99.

K.-E. Jang, K.-B. Seo, and S.-J. Lee, "Quantitative Assessment of Balance Using Balance Index," Journal. Of Korean Academy of Rehabilitation. Medicine. vol. 18, no. 3, Sep. 1994, pp.561-569.

B.-Y. Hwang, "Characteristics of LOS and Body Sway in the Patients," Natural Sciences., Yong-In University. vol. 7, no. 1, Dec. 2002, pp.135-140.

M. De Haart, A. C. Geurts, S. C. Huidekoper, L. Fasotti, and, J. van Limbeek, "Recovery of standing balance in post acute stroke patients: a rehabilitation cohort study," Archives of Physical Medicine and Rehabilitation, vol.85, no. 6, Jun. 2004, pp.886-895.

A.A. Rizzo, T. Bowerly, J. G. Buckwalter, D. Klimchuk, R. Mitura, and T. D. Parsons, "A virtual reality scenario for all seasons: the virtual classroom," CNS Spectr, vol. 11, no.1, Jan. 2006, pp.35-44.

Altschuler EL, Sidney B, Wisdom SL, Foster C, Galasko D, Llewellyn DM, et al. Rehabilitation of hemiparesis after stroke with a mirror. Lancet 1999; 353:2035e6.

Small SL, Buccino G, Solodkin A: The mirror neuron system and treatment of stroke. Dev Psychobiol, 2012, 54: 293–310.

K. Sathian, I. Arlene, Greenspan and L. Steven Wolf, "Doing It with Mirrors: A Case Study of a Novel Approach to Neurorehabilitation," Neurorehabil Neural Repair, vol.14, no. 1, Mar. 2000, pp.73-76.

J. A. Stevens, and M. E. P. Stoykov, "Using Motor Imagery in the Rehabilitation of Hemiparesis," Archives of Physical Medicine and Rehabilitation, vol. 84, no. 7, Jul. 2003, pp.1090-1092.

M.. Beninato, L. G. Portney, and P. E. Sullivan, "Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke," Physical Therapy, vol. 89, no. 8, Aug. 2009, pp.816-825.

Je-Hyeok Lee, Hyun-Joo Kim, "Effect of exercise program using mirrors for stroke patients,"International Journal of Contents, Vol.9, No.1, Mar 2013.

Ted J Stevenson, "Detecting change in patients with stroke using the Berg Balance Scale, "Australian Journal of Physiotherapy Vol. 47, 2001.






Pilot Study

How to Cite

Rai, S., & Das, A. . (2021). The Effect Of Exercises To Improve Balance Using Mirror As A Feedback In Stroke Patients- Pilot Study. VIMS JOURNAL OF PHYSICAL THERAPY, 2(2).