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


  • 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)


Video on how to make a mirror box

Leave a Comment

More To Read

How Weather Changes Affect Joint Pain

January 7, 2023

By: Lucas Godwin How Weather Changes Affect Joint Pain Numerous potential factors can cause weather-related joint pain, including humidity, temperature, precipitation, and changes in barometric pressure. Scientists have performed many studies on joint pain and weather over the years, but so far, none can say for sure what the connection is. Timmermans et al., 2015…

Read More

When should you use a Static Progressive Splint in Hand Therapy?

February 2, 2020

Flowers, K. (2002). A proposed decision hierarchy for splinting the stiff joint, with an emphasis on force application parameters. Journal of Hand Therapy, 15, 158–162. The Skinny- The article proposes a decision hierarchy to determine when you should apply a static progressive or dynamic orthosis.  The decision hierarchy uses a modified Weeks test (MWT). The…

Read More

Ways to Improve HEP Compliance  in Hand Therapy 

April 17, 2022

Ways to Improve HEP Compliance  in Hand Therapy  By: Dalton Busch  One of the most important ways we see our patient’s progress is by assuring they are compliant with their prescribed home exercise program (HEP). Our patients are always encouraged to adhere to their prescribed program but compliance is easier said than done. Reminding patients…

Read More

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.