Mirror helps beat paralysis

Patients using the mirror showed significant improvement

Stroke patients with partial paralysis could benefit from a therapy that tricks the mind into thinking the frozen limb can move.

The technique uses a reflection of the patient's good side so at appears as if the left moves with the right or vice versa.

It has been used to explore the phenomenon of phantom limbs in amputees.

Most of the stroke patients in the study made better progress when using the mirror therapy than when performing the same exercises with a sheet of clear plastic.

The researchers, who publish their findings in The Lancet medical journal, followed the progress of nine patients with hemiparesis.

It is one of the most common and disabling conditions in people who have suffered a stroke, and is characterised by partial paralysis of one side of the body.

Dr Eric Altschuler and colleagues from the Brain and Perception Laboratory of the University of California, noted that the sensation of movement in an amputated hand or arm could be evoked using a mirror - the so-called phantom limb effect.

They decided to assess whether it could have an effect on the ability to move of stroke patients.

"These patients, as well as having trouble with moving - the output - have trouble with knowing where their limbs are - the input," Dr Altschuler told BBC News Online.

"In the mirror the good hand looks like the bad hand so it looks like it's moving even though it's not. So we feed the brain the proper input visually and we hope that helps the output."

The patients the researchers studied had all had a stroke at least six months earlier and were put on four weeks therapy either with a mirror or with a piece of clear plastic.

Practice schedule

Patients assigned mirror therapy were placed on a practice schedule of 15 minutes twice daily for six days a week.

The practice involved trying to move their hands or arms symmetrically while watching their good arm in the mirror.

Substantially more patients improved on the mirror therapy than on the control therapy, and patients reported that they preferred the mirror therapy.

"As you're watching you practice and every day you get a little better," Dr Altschuler said.

"It's not a magic technique. It's like a baby or an athlete - the more they practice the better they get."

He stressed that all patients would have different needs and should get an individual rehabilitation programme from their doctor.

"2,500 years ago hip said its impossible to cure a severe case of stroke and nearly impossible to cure a slight one, and there really hasn't been any improvement in 2,500 years.

"We think the mirror is helpful, and many patients could find it helpful."

One patient quoted in the study described the therapy as "a blessing". Another patient said that although "all my other methods of therapy exercise my muscles, the mirror is the only one which exercises my brain and nerves".

"The best thing about it," Dr Altschuler said, "is it's cheap, safe, easy and it's fun."