Mirror therapy versus functional electrical stimulation cycling in post-stroke lower limb rehabilitation: a randomized controlled trial
In brief
Mirror therapy and electrical cycling improved leg motor scores after stroke
In a 45-patient trial, six weeks of mirror therapy or electrical stimulation-assisted cycling alongside rehabilitation improved leg motor scores more than conventional rehabilitation alone. Cycling also showed greater gains in movement stage and stroke-related quality of life, but it did not significantly outperform mirror therapy; the small study leaves their comparative benefits uncertain.
- Journal
- Topics in stroke rehabilitation (Q1)
- Published
- 1 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Muhammed Sefa Çınar, Engin Koyuncu, Tuğba Atan, Eda Gürçay
- PMID
- 42820841
- DOI
- 10.1080/10749357.2026.2742170
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 2 October 2026): Mirror therapy improves lower limb motor function
Abstract
BACKGROUND: Stroke commonly leads to lower extremity motor impairment and reduced quality of life. Adjunctive rehabilitation approaches are often required to enhance recovery during the subacute phase. OBJECTIVES: To compare the effects of mirror therapy (MT) and functional electrical stimulation-assisted cycling (FES-C) as adjuncts to conventional rehabilitation in patients with subacute stroke. METHODS: Forty-five patients were randomly assigned to a control, MT, or FES-C group (n = 15 each). All participants received conventional rehabilitation, with 30 minutes replaced by MT or FES-C in the groups, 5 days per week for six weeks. Outcomes were assessed before and after treatment using the Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Brunnstrom stage, Functional Independence Measure-Motor, Berg Balance Scale, Functional Ambulation Classification, and Stroke-Specific Quality of Life Scale (SS-QOL). RESULTS: All groups showed significant within-group improvements (p < 0.05). Compared with control, both the MT (mean difference [MD] -2.60, 95% CI - 5.83 to -0.63, p = 0.004) and FES-C groups (MD - 3.00, 95% CI - 6.23 to -0.23, p = 0.008) demonstrated greater improvements in ΔFMA-LE scores. Only the FES-C group showed significantly greater gains in ΔBrunnstrom stage (MD - 0.80, 95% CI - 1.49 to -0.10, p = 0.007) and ΔSS-QOL (MD - 19.40, 95% CI - 35.70 to -3.09, p = 0.015). No significant differences were observed between MT and FES-C (p > 0.05). CONCLUSIONS: Despite the more advanced technological features of FES-C, MT also achieved improvements in lower extremity motor function, supporting its use as a simple and accessible adjunct intervention for post-stroke lower extremity rehabilitation. CLINICALTRIALS.GOV: NCT06558721. CLINICAL TRIAL REGISTRATION NUMBER: The study was registered at the US National Institutes of Health (ClinicalTrials.gov) (NCT06558721) and available a https://clinicaltrials.gov/study/NCT06558721?term=sefa%20c%C4%B1nar&rank=1.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.