HemiplegiaNCT04913506
Evaluation of the Effects of Neuromuscular Electrical Stimulation and Mirror Therapy in Hemiplegia Rehabilitation
A study testing Group Mirror, Group NMES and Group Mirror+NMES in people with Hemiplegia and Upper Extremity Dysfunction, run by Bursa Yuksek Ihtisas Training and Research Hospital at 1 site in Turkey (Türkiye).
Trial summary
In this study, it was aimed to evaluate whether or not NMES in front of the mirror brings an additional benefit to mirror therapy alone or NMES alone on upper extremity motor and functional development, spasticity, anxiety, depression, cognitive function and activities of daily living, and neuropathic pain. Read more about this study
- Who is it for?
- Ages 18 to 85 years
- Conditions the study is for
- Hemiplegia, Upper Extremity Dysfunction
- What is being tested?
- Group Mirror, Group NMES and Group Mirror+NMES
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jun 2021to 1 Jan 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Subacute hemiplegia
- Patients who can communicate well, are motivated enough and are willing to participate in the study
- Patients' medical conditions are stable
- Initiation of voluntary extension movement in the wrist (lower limit)
Who cannot join
- The presence of more than one previous cerebrovascular disease (except transient ischemic attack).
- Presence of flaccid hemiplegia.
- Presence of a previous neurological disease causing a decrease in strength in the affected extremity.
- Presence of deformity due to a previous fracture, inflammatory arthropathy, etc. in the affected extremity.
- Presence of more than grade 3 spasticity in upper extremity according to Modified Ashworth Scale
- Use of cardiac pace maker
- Presence of fatal cardiac arrhythmia
- Presence of seizure history within 2 years.
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi
Bursa, 16320
About this study
Official title: Evaluation of the Effects of Neuromuscular Electrical Stimulation and Mirror Therapy in Hemiplegia Rehabilitation; Prospective, Randomized, Controlled, Single-Blinded Study
In this study, it was aimed to evaluate whether or not NMES in front of the mirror brings an additional benefit to mirror therapy alone or NMES alone on upper extremity motor and functional development, spasticity, anxiety, depression, cognitive function and activities of daily living, and neuropathic pain.
Read the detailed description
Cerebrovascular diseases are the general name given to clinical neurological pictures that occur as a result of pathological changes in the blood vessels of the primary lesion and / or in the properties of the blood passing through them. Many complications develop in the acute and chronic periods in patients with stroke, and the rate of complication development has been reported to vary between 40-96% in different studies. The aim of hemiplegic upper extremity rehabilitation is to prevent complications and improve lost motor-sensory control. Upper limb rehabilitation is less successful than lower limb rehabilitation because the upper limb is more functional and more complex.
For muscle reeducation, NMES is used to strengthen inhibited muscle groups, facilitate voluntary isolated muscle contraction, prevent muscle atrophy, increase metabolism and enzyme activity, change the contractile properties of the muscle, maintain or increase the normal range of motion of the joint, develop voluntary movement and functional gains. NMES has been used in hemiplegia rehabilitation since 1960 for the purpose of functional retraining of muscles. The purpose of this treatment is to enable the muscles with impaired neural function of the electrical current to perform a functional and useful movement.
Applications in front of the mirror are thought to trigger the neuronal connections in the motor cortex associated with the imagined movement. Findings obtained from studies with functional magnetic resonance support this theory. Compared to conventional PR, applications in front of the mirror are thought to have more and longer-lasting effects.
- Conditions
- Hemiplegia, Upper Extremity Dysfunction
- Being tested
- Group Mirror, Group NMES, Group Mirror+NMES
- Keywords
- hemiplegia, mirror theraphy, NMES
- Medical subject headings
- Hemiplegia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Group MirrorOther
Also called Mirror theraphy
For 30 minutes, ROM exercises will be applied to the solid upper extremity in all directions in front of a real mirror by the practitioner. (3 weeks, 5 days a week, 15 sessions in total)
Group NMESDevice
Also called NMES (neuromuscular electrical stimulation)
NMES will be applied to the hemiplegic arm(deltoid, elbow extensors and forearm) for 30 minutes by the practitioner (3 weeks, 5 days a week, 15 sessions in total)
Group Mirror+NMESOther
Also called Mirror therapy+NMES
The practitioner will be synchronized with visual or auditory stimuli, and ROM exercises in all directions in front of the real mirror for 30 minutes, and NMES therapy for 30 minutes on the paretic upper extremity will be applied together. (3 weeks, 5 days a week, 15 sessions in total)
| Study group | Role | What they receive |
|---|---|---|
| Group Mirror | Active comparator | Along with conventional rehabilitation techniques, patients will be given ROM exercises in all directions, in front of the real mirror, by the practitioner on the healthy upper extremity for 30 minutes. Receives: Other: Group Mirror |
| Group NMES | Active comparator | Along with conventional rehabilitation techniques, NMES will be applied to the hemiplegic arm for 30 minutes by the practitioner while the patients are sitting in a chair. Receives: Device: Group NMES |
| Group Mirror+NMES | Active comparator | In addition to conventional rehabilitation techniques, patients will be given ROM exercises for 30 minutes in all directions in front of the real mirror to the healthy extremity, which the practitioner will synchronize with visual or auditory stimuli, and NMES treatment for 30 minutes to the paretic upper extremity. Receives: Other: Group Mirror+NMES |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fugl-Meyer Upper Extremity Motor Rating Scale
To analysis the increase in upper limb motor function Motor score: ranges from 0 (hemiplegia) to 100 points (normal motor performance). Divided into 66 points for upper extremity and 34 points for the lower extremity. Sensation: ranges from 0 to 24 points. Divided into 8 points for light touch and 16 points for position sense.
Measured: Change from Baseline Fugl-Meyer Upper Extremity Motor Rating Scale at 3rd week
Secondary outcomes (6)
Mini-Mental Test
for cognitive functions
Measured: Change from Baseline Mini-Mental Test at 3rd week
Numeric Rating Scale
for pain
Measured: Change from Baseline Numeric Rating Scale at 3rd week
Pain Detect Questionnaire
for neuropathic pain
Measured: Change from Baseline Pain Detect Questionnaire at 3rd week
Functional Independence Scale (FIM)
for daily life activities
Measured: Change from Baseline Functional Independence Scale (FIM) at 3rd week
Modified Tardieu Scale
Score, Description 0, No resistance during movement.
- There is very slight resistance during movement, but no noticeable "catch".
- There is a noticeable "catch" at a certain angle, followed by relaxation.
- Clonus occurring at a certain angle and lasting for seconds (ending with fatigue).
- Uninterrupted clonus occurring at a certain angle and lasting for more than 10 seconds. 5, The joint is too stiff to move (petrified).
Measured: Change from Baseline Modified Tardieu Scale at 3rd week
Brunnstrom stages
For improvement of upper limb motor function
Measured: Change from Baseline Brunnstrom stages at 3rd week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jun 2021
- Study start1 Jun 2021
- Primary completion1 Oct 2022
- Study completion1 Jan 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for HemiplegiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Prospective, Randomized, Controlled, Single-Blinded Study
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 42 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bursa Yuksek Ihtisas Training and Research Hospital
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Dr. Burcu Metin Ökmen, Bursa Yuksek Ihtisas Training and Research Hospital
- Investigators
- Burcu Metin Ökmen, M.D. Assoc. Prof, Principal investigator, Bursa Yuksek Ihtisas Training and Research HospitalBüşra Yeşil, M.D., Study chair, Bursa Yuksek Ihtisas Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04913506
- Sponsor's protocol ID
- BYIEAH-H
- Status last verified
- Feb 2026
- First submitted
- 26 May 2021
- Last updated
- 11 Feb 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of the Effects of Neuromuscular Electrical Stimulation and Mirror Therapy in Hemiplegia Rehabilitation; Prospective, Randomized, Controlled, Single-Blinded Study
- ClinicalTrials.gov ID
- NCT04913506
- Acronym / sponsor ID
- BYIEAH-H
- Conditions
- Hemiplegia, Upper Extremity Dysfunction
- Keywords
- hemiplegia, mirror theraphy, NMES
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 42 participants (actual)
- Lead sponsor
- Bursa Yuksek Ihtisas Training and Research HospitalOther government
- Study start
- 1 Jun 2021 (actual)
- Primary completion
- 1 Oct 2022 (actual)
- Study completion
- 1 Jan 2023 (actual)
- First posted
- 4 Jun 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In this study, it was aimed to evaluate whether or not NMES in front of the mirror brings an additional benefit to mirror therapy alone or NMES alone on upper extremity motor and functional development, spasticity, anxiety, depression, cognitive function and activities of daily living, and neuropathic pain.
Detailed description
Cerebrovascular diseases are the general name given to clinical neurological pictures that occur as a result of pathological changes in the blood vessels of the primary lesion and / or in the properties of the blood passing through them. Many complications develop in the acute and chronic periods in patients with stroke, and the rate of complication development has been reported to vary between 40-96% in different studies. The aim of hemiplegic upper extremity rehabilitation is to prevent complications and improve lost motor-sensory control. Upper limb rehabilitation is less successful than lower limb rehabilitation because the upper limb is more functional and more complex.
For muscle reeducation, NMES is used to strengthen inhibited muscle groups, facilitate voluntary isolated muscle contraction, prevent muscle atrophy, increase metabolism and enzyme activity, change the contractile properties of the muscle, maintain or increase the normal range of motion of the joint, develop voluntary movement and functional gains. NMES has been used in hemiplegia rehabilitation since 1960 for the purpose of functional retraining of muscles. The purpose of this treatment is to enable the muscles with impaired neural function of the electrical current to perform a functional and useful movement.
Applications in front of the mirror are thought to trigger the neuronal connections in the motor cortex associated with the imagined movement. Findings obtained from studies with functional magnetic resonance support this theory. Compared to conventional PR, applications in front of the mirror are thought to have more and longer-lasting effects.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Prospective, Randomized, Controlled, Single-Blinded Study
| Arm | Type | Receives |
|---|---|---|
| Group Mirror | Active comparator | Other: Group MirrorAlong with conventional rehabilitation techniques, patients will be given ROM exercises in all directions, in front of the real mirror, by the practitioner on the healthy upper extremity for 30 minutes. |
| Group NMES | Active comparator | Device: Group NMESAlong with conventional rehabilitation techniques, NMES will be applied to the hemiplegic arm for 30 minutes by the practitioner while the patients are sitting in a chair. |
| Group Mirror+NMES | Active comparator | Other: Group Mirror+NMESIn addition to conventional rehabilitation techniques, patients will be given ROM exercises for 30 minutes in all directions in front of the real mirror to the healthy extremity, which the practitioner will synchronize with visual or auditory stimuli, and NMES treatment for 30 minutes to the paretic upper extremity. |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Subacute hemiplegia
- Patients who can communicate well, are motivated enough and are willing to participate in the study
- Patients' medical conditions are stable
- Initiation of voluntary extension movement in the wrist (lower limit)
Key exclusion criteria (8 listed)
- The presence of more than one previous cerebrovascular disease (except transient ischemic attack).
- Presence of flaccid hemiplegia.
- Presence of a previous neurological disease causing a decrease in strength in the affected extremity.
- Presence of deformity due to a previous fracture, inflammatory arthropathy, etc. in the affected extremity.
- Presence of more than grade 3 spasticity in upper extremity according to Modified Ashworth Scale
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Group MirrorAlso: Mirror theraphyFor 30 minutes, ROM exercises will be applied to the solid upper extremity in all directions in front of a real mirror by the practitioner. (3 weeks, 5 days a week, 15 sessions in total) | Other | Group Mirror |
| Group NMESAlso: NMES (neuromuscular electrical stimulation)NMES will be applied to the hemiplegic arm(deltoid, elbow extensors and forearm) for 30 minutes by the practitioner (3 weeks, 5 days a week, 15 sessions in total) | Device | Group NMES |
| Group Mirror+NMESAlso: Mirror therapy+NMESThe practitioner will be synchronized with visual or auditory stimuli, and ROM exercises in all directions in front of the real mirror for 30 minutes, and NMES therapy for 30 minutes on the paretic upper extremity will be applied together. (3 weeks, 5 days a week, 15 sessions in total) | Other | Group Mirror+NMES |
Primary outcome
Fugl-Meyer Upper Extremity Motor Rating Scale
Time frame: Change from Baseline Fugl-Meyer Upper Extremity Motor Rating Scale at 3rd week
To analysis the increase in upper limb motor function Motor score: ranges from 0 (hemiplegia) to 100 points (normal motor performance). Divided into 66 points for upper extremity and 34 points for the lower extremity. Sensation: ranges from 0 to 24 points. Divided into 8 points for light touch and 16 points for position sense.
6 secondary outcomes
Mini-Mental Test
Time frame: Change from Baseline Mini-Mental Test at 3rd week
Numeric Rating Scale
Time frame: Change from Baseline Numeric Rating Scale at 3rd week
Pain Detect Questionnaire
Time frame: Change from Baseline Pain Detect Questionnaire at 3rd week
Functional Independence Scale (FIM)
Time frame: Change from Baseline Functional Independence Scale (FIM) at 3rd week
Modified Tardieu Scale
Time frame: Change from Baseline Modified Tardieu Scale at 3rd week
Brunnstrom stages
Time frame: Change from Baseline Brunnstrom stages at 3rd week
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Feb 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Burcu Metin Ökmen, M.D. Assoc. Prof principal investigator
Bursa Yuksek Ihtisas Training and Research Hospital
Büşra Yeşil, M.D. study chair
Bursa Yuksek Ihtisas Training and Research Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Group Mirror, Group NMES and Group Mirror+NMES in people with Hemiplegia and Upper Extremity Dysfunction, run by Bursa Yuksek Ihtisas Training and Research Hospital at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fugl-Meyer Upper Extremity Motor Rating Scale (time frame: Change from Baseline Fugl-Meyer Upper Extremity Motor Rating Scale at 3rd week). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Feb 2026.