Comparative effectiveness of mirror therapy using different delivery media on motor recovery of the upper limb and hand in stroke patients: A systematic review and network meta-analysis
In brief
Virtual reality mirror therapy raised stroke arm function scores by 8.75 points
In a review of 30 trials involving 1,212 people after stroke, virtual reality mirror therapy had the largest estimated improvement in upper limb function versus control, with scores 8.75 points higher. It also outperformed traditional mirror therapy for hand function, but most comparisons were indirect and evidence for hand recovery was very uncertain; head-to-head trials are needed.
- Journal
- Clinical rehabilitation (Q1)
- Published
- 27 October 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Bin Shi, Guangxue Zhou, Ning Xu
- PMID
- 42935261
- DOI
- 10.1177/02692155261501002
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 1 November 2026): Comparative mirror therapy evidence for post-stroke motor recovery
Abstract
ObjectiveThis study aimed to compare the effects of mirror therapy delivered through different media on upper limb and hand motor recovery in stroke patients using a network meta-analysis.Data sourcesFive electronic databases were searched from inception to 7 September 2026.Review methodsMethodological quality was assessed using the Cochrane risk-of-bias tool (RoB 2.0). A Bayesian framework was applied for network meta-analysis, and evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation.ResultsThirty trials involving 1212 participants were included, covering three mirror therapy modalities. Network meta-analysis showed that, compared with control group, virtual reality-based mirror therapy (mean difference [MD] = 8.75; 95% credible interval [CrI]: 4.56 to 13.30), digital screen-based mirror therapy (MD = 6.95; 95% CrI: 3.18 to 10.48), and traditional mirror therapy (MD = 5.29; 95% CrI: 2.58 to 7.70) significantly improved upper limb motor function. For hand motor function, virtual reality-based mirror therapy was superior to the control group (MD = 4.65; 95% CrI: 1.06 to 8.16) and traditional mirror therapy (MD = 3.77; 95% CrI: 0.54 to 7.14). Virtual reality-based mirror therapy consistently ranked as the most effective intervention. The certainty of evidence ranged from very low to moderate.ConclusionVirtual reality-based mirror therapy showed the most favourable exploratory effect estimates, but the relative efficacy of different delivery media remains uncertain because most comparisons were indirect and the certainty of evidence for hand motor function was very low. Head-to-head trials are needed to confirm these findings.
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.