Effectiveness of mirror therapy to treat musculoskeletal injuries of the hand and wrist: A systematic review

BACKGROUND: Mirror therapy is an effective intervention for improving outcomes when an affected extremity has severe movement restrictions or pain. PURPOSE: To investigate the effects of mirror therapy interventions on musculoskeletal injuries of the hand/wrist. STUDY DESIGN: Systematic review. METHODS: This systematic review was conducted in accordance with Cochrane and PRISMA guidelines and registered with Open Science Framework (DOI:XXX). The search was conducted in EMBASE, PubMed, and Scopus in April 2024. Search terms included hand and wrist injuries, mirror therapy, pain, range of motion, strength, and function. Descriptive synthesis was used to summarize the data for interventions and outcomes. The Cochrane RoB 2 tool was used for quality assessment. RESULTS: Samples ranged from 22 to 40 participants with a total of 220 participants. Five studies combined mirror therapy with active exercise and had comparator groups performing active exercises for the same duration. Mirror therapy intervention ranged from 20 to 75 minutes per session, two to five times a week for 3-8weeks. Mirror therapy interventions reduced pain, improved range of motion, strength, and function in most studies. Greater improvements for the mirror therapy groups than the comparator group were reported for pain, range of motion, and function in 20%-75% of the studies. Risk assessment for the seven studies resulted in one high, four moderate, and two low quality studies. CONCLUSIONS: Moderate quality evidence suggests that mirror therapy interventions may be effective at reducing pain, improving range of motion, strength and function for musculoskeletal hand and wrist injuries. Further investigation is warranted with larger trials with more homogenous interventions.