The goal of this clinical trial is to find out whether Mirror Therapy (MT) combined with Constraint-Induced Movement Therapy (CIMT) improves hand and arm function after a stroke. The study will also compare this combination to CIMT alone. The main questions it aims to answer are:

Does combining MT with CIMT improve grip strength, hand dexterity, and upper limb function more than CIMT alone? Which therapy is more effective in helping stroke survivors regain use of their arm and hand?

Participants will:

Be randomly assigned to receive either CIMT alone or CIMT combined with MT Attend therapy sessions 5 days a week for 6 weeks, each lasting 60-90 minutes Undergo tests before and after treatment to measure grip strength, dexterity, and motor function using tools like the Fugl-Meyer Assessment, Box and Block Test, and Hand-Held Dynamometer

This randomized clinical trial aims to evaluate and compare the effects of Mirror Therapy (MT) and Constraint-Induced Movement Therapy (CIMT) on grip strength, hand dexterity, and upper limb motor function in post-stroke patients. Stroke is a leading cause of long-term disability, particularly affecting upper limb motor function, which severely impacts the ability to perform daily activities. This study seeks to provide insights into which approach or combination of therapies is more effective in improving upper limb functionality in post-stroke patients, thereby enhancing their quality of life and rehabilitation outcomes.

In this study, a randomized clinical trial (RCT) methodology will be utilized. 32 participants male and female patients aged 40 years and above who have a confirmed diagnosis of stroke, verified through CT scan and MRI imaging will be included. Eligible participants will have experienced a stroke within the past six months to ensure relevance to the intervention and recovery phase. Additionally, only those with a Brunnstrom grade of 2 or higher, indicating some degree of voluntary motor function, will be included by using non-probability convenience sampling and randomly divided into two groups: one receiving only CIMT and the other combining MT with CIMT. Baseline measurements will be taken for all participants to assess grip strength, hand dexterity, and upper limb motor function, utilizing validated tools like the Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), Box and Block Test (BBT), and Hand-Held Dynamometer. Both groups will undergo therapy sessions five days a week for six weeks, with daily sessions lasting 60-90 minutes. The data analysis will be performed using SPSS version 25. Data normality will be checked via the Shapiro-Wilk test. To evaluate within-group changes between pre- and post-treatment measurements, the Wilcoxon signed-rank test will be used, as it is appropriate for non-parametric data. The Mann-Whitney U test, a non-parametric test for comparing two independent groups.

Inclusion Criteria:

• Male and female patients
• Age 40 years and above
• Diagnosed patients confirmed by CT scan and MRI
• History of stroke not more than 6 months
• Brunnstrom grade 2 and above

Exclusion Criteria:

• Patients having history of musculoskeletal disorders
• History of shoulder injuries or adhesive capsulitis
• Patients having visual and auditory deficit will be excluded
• Patients who have sensory deficit will be excluded