Comparison of the Effects of Mirror Therapy, Repetitive Transcranial Magnetic Stimulation and Robotic-assisted Hand Therapy Added to Neurological Rehabilitation on Upper Extremity Functions, Quality of Life and Pain in Stroke Patients

What this Trial Is About

Researchers are studying how three different therapies—mirror therapy, Repetitive Transcranial Magnetic Stimulation (rTMS), and robot-assisted hand therapy—added to standard neurological rehabilitation affect upper limb function, quality of life, and pain in adults who have had a stroke. Stroke is a major cause of disability and death, and despite advances, recovery of arm function and pain relief remain challenging. This study compares these newer rehabilitation methods to better understand their impact on stroke recovery. Participants will be randomly assigned to one of three groups. All groups receive 20 sessions of conventional neurological rehabilitation over 4 weeks. The first group will also have 20 sessions of mirror therapy focused on the upper limb. The second group will receive 20 sessions of low-frequency rTMS targeting the brain's motor cortex controlling the affected arm. The third group undergoes 20 sessions of robot-assisted hand therapy using the AMADEO device. Each therapy is applied five days per week during the 4-week period. During the study, participants will be evaluated twice—before treatment and at the end of 4 weeks—using various tests and questionnaires assessing arm movement, mental status, spasticity, hand function, pain, mood, sleep quality, and quality of life. Measurements include the Fugl Meyer Upper Extremity Assessment as the primary outcome, along with other scales such as the Brunnstrom Staging, Modified Ashworth Scale, and neuropathic pain assessments. These evaluations aim to capture improvements in function, pain relief, and overall well-being related to each therapy.

Comparison of the Effects of Mirror Therapy,rTMS and Robotic-assisted Hand Therapy in Stroke Patients