Mirror Therapy

Mirror therapy has many implications for therapy and can be used to treat many diagnoses that commonly involve the upper extremity. These include some of the Neuro Conditions we highlighted last week including, Stroke and Focal Hand Dystonia. Btw, you can download a mirror therapy exercises pdf here for free.

mirror therapy exercises pdf

How long should the patient perform mirror therapy exercises? Should there be a sequence of routines prior to performing mirror therapy?  There is no simple answer and a wide range of dosing information along with frequency and duration for performing mirror box therapy. 

Despite the variety in rehab regimes for mirror therapy, the majority of them have demonstrated positive effects.  From the studies, a general protocol was developed know as the St. Gallen MT Protocol. The St. Gallen MT Protocol was tested on 52 patients.  Of those, 42 out of 52  patients showed a reduction in pain, improved function, and no phantom sensations.  

Here are some key highlights from the studies and the St. Gallen MT Protocol.  

Keys to using mirror therapy in treatment

  • Explain clearly how mirror therapy works, the patient must have the buy-in
  • Perform mirror therapy in a quiet environment
  • Set up a home program using mirror therapy (mirror therapy boxes) can be made out of cardboard boxes by gluing a handheld mirror on the side or you can fabricate a wooden one for under $15 (see below video below).
  • Utilize a patient log for tracking mirror therapy exercises. 
  • Review patient log at follow-up therapy visits

Duration 

  • Home Program must be performed 5-6x/day,
  • Each session should be  no longer than 5-10 minutes 
  • Adapt exercise based on diagnosis

Grunert-Pluss, N., Hugschmid, U., & Santschi, L. (2008). Mirror therapy in hand rehabilitation: A review of the literature, the st gallen protocol for mirror therapy and evaluation of a case series of 52 patients, 13, 1, 4-11.  

Supply list for making a mirror box (mirror therapy handout)

https://www.handtherapyacademy.com/wp-content/uploads/2019/06/mirror-box-material-list-.pdf

Video on how to make a mirror box

2 Comments

  1. Marietta Okada on June 4, 2025 at 8:17 am

    I need help creating a similar box but the one I want has the mirror inside glued to box and has a 3 inch opening in the top wood above the mirror so you need to be standing up looking through opening to view the mirror and see your hand writing on paper (which of course will be reversed and challenging to even print your name.) I had one years ago and used it for children and Adults to learn about Dyslexia. Hoping you can help!

    • Miranda Materi on July 26, 2025 at 7:09 am

      Sounds like a fun project. good luck and let us know how it turns out.

Leave a Comment






More To Read

Carpal Tunnel Release: Outcomes of Pediatric and Adolescent

June 19, 2022

Rapid Review. Outcomes of pediatric and adolescent carpal tunnel release based on etiology. Velicki, K., Goldfarb, C. A., Roberts, S., & Wall, L. B. (2021). Outcomes of pediatric and adolescent carpal tunnel release. The Journal of Hand Surgery, 46(3), 178-186. The Skinny: Less than 1% of pediatric carpal tunnel is idiopathic in nature, compared to…

Comparison of Erb’s Palsy and Klumpke’s Palsy: Symptoms, Presentation, and Treatment Options

June 2, 2024

What is the brachial plexus? The brachial plexus is a group of nerves originating from the cervical and thoracic nerve roots (from C5 to T1). The brachial plexus forms 5 peripheral nerves of the upper extremity, consisting of the musculocutaneous, median, radial, ulnar, and axillary nerves. This group of nerves supplies motor and sensory innervation…

Outcomes of Rigid Night Splinting and Activity Modification in the Treatment of Cubital Tunnel Syndrome

November 8, 2020

Shah, C. M., Calfee, R. P., Gelberman, R. H., & Goldfarb, C. A. (2013). Outcomes of rigid night splinting and activity modification in the treatment of cubital tunnel syndrome (night splint for cubital tunnel syndrome). The Journal of Hand Surgery, 38(6), 1125–1130.e1. https://doi.org/10.1016/j.jhsa.2013.02.039 By: Sophia Grimm The Skinny: The purpose of this study was to…

How To Do A Fast but Thorough Hand Therapy Assessment

July 1, 2023

We don’t get a lot of time. Sometimes new patients come in unexpectedly or someone comes at the wrong time and your 1-hour block for an eval is suddenly only 30 minutes. Do you know how to get the most out of your eval time with the patient? Do you know what things are the…

Envelope_1

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.