CONSTRAINT-INDUCED MOVEMENT THERAPY VS. MIRROR THERAPY ON HAND FUNCTION AND SPASTICITY IN PATIENTS WITH HEMIPARESIS

Authors

  • Mahnoor Aleem PT, DPT, MS(Neuro), Student, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan Author
  • Dr. Muhammad Sarfraz Associate Professor, Department of Physiotherapy, DIPMR, Dow University of Health Sciences; Author https://orcid.org/0000-0002-4654-9926
  • Abdul Mannan Clinical Physiotherapist, Doctor of Physical Therapy, The University of Faisalabad Author
  • Samia Khaliq Lecturer, Alshifa Institute of Health Sciences, Narowal, Pakistan; Consultant Physiotherapist, Iqbal Medical Complex Author
  • Sania Zahra PT, DPT, MS Neuromuscular Physical Therapy, Head of Department, ACE Institute of Medical & Emerging Sciences, Lahore, Pakistan; Author https://orcid.org/0009-0000-3664-2652
  • Iqra Waseem PT, DPT, MS (MSK), Assistant Professor, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan Author https://orcid.org/0000-0002-1487-7749

DOI:

https://doi.org/10.71000/96bh8m63

Keywords:

Activities of Daily Living; Constraint Induced Movement Therapy; Hemiparesis; Mirror Movement Therapy; Muscle Spasticity; Stroke; Upper Extremity.

Abstract

Background: Hemiparesis commonly affects upper limb control and limits hand use during daily activities. Reduced voluntary movement, impaired dexterity, and spasticity may delay functional independence and reduce participation in rehabilitation. Constraint-Induced Movement Therapy and Mirror Therapy are widely used neurorehabilitation approaches that aim to promote motor recovery through different mechanisms. However, direct evidence comparing their effects on hand function and spasticity over a structured intervention period remains limited.

Objective: To compare the effects of Constraint-Induced Movement Therapy and Mirror Therapy on hand function and spasticity in patients with hemiparesis.

Methods: A single-blinded randomized controlled trial was conducted on 68 patients with hemiparesis. Participants were randomly allocated into two equal groups, with 34 patients in the Constraint-Induced Movement Therapy group and 34 patients in the Mirror Therapy group. Both groups received their assigned intervention for 8 weeks along with routine physiotherapy care. Hand function was assessed using the Fugl-Meyer Assessment-Upper Extremity, while spasticity was evaluated using the Modified Ashworth Scale. Assessments were recorded at baseline, 4th week, and 8th week. Data were analyzed using descriptive statistics, repeated-measures ANOVA, and independent-samples t-test, with statistical significance set at p < 0.05.

Results: The mean age was 53.65 ± 8.05 years in the Constraint-Induced Movement Therapy group and 53.41 ± 7.14 years in the Mirror Therapy group. Modified Ashworth Scale scores decreased from 2.06 ± 0.47 to 0.98 ± 0.65 in the Constraint-Induced Movement Therapy group and from 2.02 ± 0.65 to 1.00 ± 0.42 in the Mirror Therapy group. Fugl-Meyer Assessment-Upper Extremity scores increased from 31.17 ± 4.60 to 40.45 ± 5.69 in the Constraint-Induced Movement Therapy group and from 30.49 ± 5.70 to 41.68 ± 5.78 in the Mirror Therapy group. Within-group improvement was significant for both outcomes over time, with p < 0.001. Between-group differences remained statistically non-significant at all assessment points.

Conclusion: Both interventions improved hand function and reduced spasticity in patients with hemiparesis. Mirror Therapy showed slightly greater motor improvement within the 8-week period, suggesting its practical value as an accessible and patient-friendly rehabilitation option.

Keywords: Activities of Daily Living; Constraint Induced Movement Therapy; Hemiparesis; Mirror Movement Therapy; Muscle Spasticity; Stroke; Upper Extremity.

Author Biographies

  • Mahnoor Aleem, PT, DPT, MS(Neuro), Student, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan

    PT, DPT, MS(Neuro), Student, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan

  • Dr. Muhammad Sarfraz, Associate Professor, Department of Physiotherapy, DIPMR, Dow University of Health Sciences;

    Associate Professor, Department of Physiotherapy, DIPMR, Dow University of Health Sciences;

  • Abdul Mannan, Clinical Physiotherapist, Doctor of Physical Therapy, The University of Faisalabad

    Clinical Physiotherapist, Doctor of Physical Therapy, The University of Faisalabad

  • Samia Khaliq, Lecturer, Alshifa Institute of Health Sciences, Narowal, Pakistan; Consultant Physiotherapist, Iqbal Medical Complex

    Lecturer, Alshifa Institute of Health Sciences, Narowal, Pakistan; Consultant Physiotherapist, Iqbal Medical Complex

  • Sania Zahra, PT, DPT, MS Neuromuscular Physical Therapy, Head of Department, ACE Institute of Medical & Emerging Sciences, Lahore, Pakistan;

    PT, DPT, MS Neuromuscular Physical Therapy, Head of Department, ACE Institute of Medical & Emerging Sciences, Lahore, Pakistan;

  • Iqra Waseem, PT, DPT, MS (MSK), Assistant Professor, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan

    PT, DPT, MS (MSK), Assistant Professor, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan

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Published

2026-05-23

Issue

Vol. 4 No. 4 (2026): Volume 4 Issue 4, 2026

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Articles

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Copyright (c) 2026 Mahnoor Aleem, Dr. Muhammad Sarfraz, Abdul Mannan, Samia Khaliq, Sania Zahra, Iqra Waseem (Author)

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