Comparative Effects of Functional Electrical Stimulation and Mirror Therapy for Foot Clearance Among Patients With Sub-acute Stroke

Summary

This study aims to evaluate the effectiveness of two rehabilitation techniques- Functional Electrical Stimulation (FES) and Mirror Therapy (MT)-in improving motor recovery among stroke survivors. Stroke often results in long-term impairments, particularly in foot clearance, which is critical for daily activities. Although current rehabilitation strategies help, more effective solutions are needed to enhance recovery. Participants, aged 18- 85 years old with subacute stroke and foot clearance impairments, will be randomized into two groups: Group A will receive functional electrical stimulation (FES) with routine physical therapy; and Group B will receive mirror therapy (MT) with routine physical therapy. The interventions will take place three times a week for 4 weeks, and participants will undergo motor function assessments, including the Fugl-Meyer Assessment and Functional Independence Measure, before and after the intervention. The study will compare the effects of each intervention on motor recovery, specifically focusing on tibialis anterior function and motor control. The findings could lead to improved rehabilitation protocols, offering stroke survivors better therapeutic options and enhancing their quality of life.

Conditions

• Stroke (Subacute)

Interventions

OTHER

Neuromodulators

Functional Electrical Stimulation was administered to participants in the experimental group to facilitate activation of the ankle dorsiflexor muscles, primarily the tibialis anterior, to improve impaired foot clearance in sub-acute stroke patients. Surface electrodes were placed over the tibialis anterior muscle of the affected limb to elicit ankle dorsiflexion. Electrical stimulation was delivered at an intensity sufficient to produce visible and functional ankle dorsiflexion without causing discomfort. The stimulation aimed to enhance neuromuscular recruitment, improve voluntary motor control, and promote motor relearning through repeated activation of the weakened muscles during functional tasks. Each FES session lasted 30 minutes, followed by 20 minutes of routine physical.

OTHER

Sensory Agumentation

Mirror Therapy was administered to participants in the comparison group as a sensory augmentation intervention to enhance motor recovery through visual feedback. A vertical mirror was placed between the lower limbs in the sagittal plane, such that the reflection of the non-paretic limb was visible while the paretic limb was concealed from view. Participants were instructed to perform repeated ankle dorsiflexion and plantarflexion movements with the non-paretic limb while observing its reflection in the mirror. This created the visual illusion that the paretic limb was moving normally, providing visual feedback to the brain. Mirror Therapy aims to stimulate mirror neuron systems and sensorimotor cortical areas, encouraging cortical reorganization and improved motor control of the affected limb. During the session, the paretic limb remained relaxed while the participant focused on the mirror image. Each Mirror Therapy session lasted 30 minutes, followed by 20 minutes of routine physical

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences

  lead OTHER

Principal Investigators

• Nabeela Dawood · Lahore University of Biological and Applied Sciences

• Rohma Shah · Lahore College of Physical Therapy

• Ayesha Hassan · Lahore College of Physical Therapy

• Rabiya Haroon · Lahore College of Physical Therapy

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

85 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-22

Primary Completion

2026-06-22

Completion

2026-06-27

Countries

• Pakistan

Study Locations