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

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