Using Mirror-box therapy

Hello wonderful Group,


Today I am trying out my mirror box, again. You will see that I use it in a slightly non-standard way. If one understands, and has experienced the brain being “tricked”, I believe all sorts of new an exciting uses for the mirror-box can be found. While it is normally used for movement of a limb, here I am using it to stimulate the feeling in my foot, thereby appeasing the horrible pins and needles (paraesthesia) I get. Ultimately, the correct interpretation of the sensations occur in the brain, of course, not in the foot itself.
Mirror therapy adapted for sensation
The above links to a little video clip I just improvised.
My hope is that hearing how others use it, and sharing ideas, might lead to better therapy. Let me know if anyone else uses a mirror box, and how.
Cheers, Roland

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@pando you mentioned in the topic below that it was a shame this post & that weren’t linked - or words to that affect. So i’ve copied in the link below. Hope thats ok. If not let me know & I’ll remove it.

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Hi Roland @pando,
I just watched your video, really great to hear and see you rather than just exchanging messages :smiley:.

As mentioned on the hand therapy thread, I was going to look out a spare mirror tile that I’ve got somewhere to try this for myself but noted the rather natty set-up that you’ve got.

Could you let me know what make it is or where you got it from because it looks like a great bit of kit.

Take care

Rich C.

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I agree, Rich.
We’re real people, and video clips can really help us express ourselves. Your turn, next!!
It’s a NOI mirror-box @£45 we got off Amazon, a year ago but it’s currently listed as unavailable
I did find this

hope that helps, ciao, Roland

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Thanks so much, Ann,

I am so dedicated to my therapy, and if I can inspire anyone else along the way, that would make me even happier

hope you’re well, ciao, Roland

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I think it is safe to say you’ve inspired many with your journey. Your determination shines through. Really hope this works for you.

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Interesting to watch Roland. It quite hard to describe that pins and needles isnt it. It’s like a fast racing sensation, much faster than true pins and needles. Who knows how many tingles in a second but it seems like a fair few.
The hard part with the foot is if course that it’s quite a long way away from your head and it’s easy for the reflection to be a long way away as well.

I was asking the physio is there any help for legs and she mentioned about it needing quite a long tall mirror. I thought something like this as an example.
It would need a stand.

For now I am going for 100% for the hand and will think about the leg later
Cheers
Nige

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@pando many thanks, I’ll look to see if I can find the NOI mirror elswhere

@Nigelglos what about a relatively cheap “full length mirror” such as the below from Dunelm - alternatively just search for “Cheval Mirror” as these are normally centrally hinged so that you can easily adjust.

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I can photograph and add the hand physio instructions on here if they would be of use ? There are about a dozen exercises and some things like holding a tennis ball, holding counters. They are geared to movement.

She mentioned to me that if you were going to use cutlery, make sure it’s the item you would normally use in the hand that shows as the image.
For me, being right handed, I will hold a fork in my left hand when eating so that would be ok to hold in my right hand for this.
A spoon or a knife in my right good hand wouldn’t work here as I don’t hold these in my left normally.
Cheers
Nige

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Yes, I have 3 speeds. Low constant hum, like electricity, or static of some kind. Then regular stronger-than your average pins n needles, and finally, a raw angry nerve that has gone hyper sensitive. This can be screaming raw pain, and usually last 3-4 seconds. Right now it’s the low-key hum

ciao, Roland

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I think like many other solutions, if there was one size fits all magic solution, we would all be doing it. Our strokes are different and perhaps which solutions work best will be as well.
The more we try, the better ?

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Just as a suggestion.
Although my left hand is hidden, I can still see the sleeve of my left arm.
I am finding I get much more convinced that it is my left hand if the hand in the mirror image looks like it’s at the end of my sleeve.

So in effects three straight lines,

  1. My left arm going behind the mirror
  2. the mirror itself
  3. My right arm alongside the mirror, slightly awkward

It instantly feels much more believable as it looks like my hand is where I would expect it to be. This is even though I can see my right hand.
90 degrees to the mirror doesn’t seem to produce anywhere near the same belief it is my left hand.

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The more accurately you can make it look the faster and easier it will be for your brain to accept the trick. After using it a while, I find that I am readily accepting and even eager for my brain to be tricked, and I believe a slight sloppy setup works fine at that stage. I found some half coconuts on Amazon at a price, so new ideas brewing.

Today, I have to setup my wife’s new computer ; trying to import her 939 contact address book exported as CSV or VCF from 12 years ago. Failing miserably, so using Excel to sort out fields. Joy (not!)

Good luck, Roland

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Hi @pando
You’ve actually got that backward Roland
It’s normally used for the treatment of phantom limb pain - normal in the sense that the idea of mirror therapy originated in the successful treatment of pain in missing limbs. That has to be neuropathic pain because there isn’t any physical limb to be experiencing the pain in.

My understanding would suggest that your mirror size will be compromising your results.
I believe that you need to create an illusion that is moderately (wholly?) convincing. Where I have seen others use mirror therapy for relief of neurological symptoms in the lower limb they have had a mirror the whole length of their leg and have sat on the floor such that They see themselves of having two legs. So the extension for #StrokeWarriors would be the whole of your affected region would be replaced by the mirror image of the working limb.

I know that you will find the major write-ups of mirror therapy in the amputee community and they will be especially on point for your usage :slight_smile:

I haven’t yet read the rest of this thread but have it bookmarked to return to later

Ciao
Simon

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I get the feeling in the stroke world Simon that it is all about movement. 9 out of 10 of the exercises I have been left with are movement related.

Can’t quite remember who it was, perhaps Rich who was looking at repeated touch for over sensitivity. This seems suitable for that as well so in addition to the hand,I’m going to explore that for my lower arm and perhaps the biceps as well.

When Roland posted above about being eager for his brain to be tricked, I feel like that as well. I think for whatever reason the brain likes it. Is it as simple as “seeing” part of a limb no longer in any discomfort

Cheers
Nige

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Exactly; the physiotherapists have seen a technique and reinterpret it for their discipline - 99% movement.
It is a technique that was initially exclusively about pain .

Thus it is described for two uses now - both have unique components and they share some components. There is some minor confusion about what characteristics support which mode of recovery.
Using mirror therapy for both modes in one person should not be a surprise but I haven’t seen it talked about outside of our circle.

I think therefore that we have greater clarity of vision about potential uses. If the SA was more listening and facilitating then we could look to them to help us confirm and or spread awareness - something to give to a community coordinator? Fingers crossed :slight_smile:

Ciao
Simon

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Yeh, completely agree. If only the appointment was someone who had those ideas and motivation.

Possibly there should be a post stroke story for all the major flavours of strokes and people could navigate from that to all the underlying information which might apply to that stroke or more generally.
There could be a picture and if you hover the mouse over the hand for example, up pops selections for you to find out more

Or you could have a brief question tree with further buttons below to press before moving onto the next Q
What type of stroke did you have?
How long ago ?
Where are you now (hospital, rehab, care home, home)
Has it left you with physical weaknesses/paralysis? (Selections for where in the body)
Are you in pain ? (Type of pain, location)
Are you suffering from fatigue ? (Severity etc)
Are you on medication?

Depending on the selections made, you might present a series of relevant pages or perhaps a print option to read at people’s leisure ?

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I can assure you, Simon

that it is really convincing… I don’t find any struggle there; I believe my left foot IS my right foot,
further, when I feel with my left, I believe my right foot is feeling the carpet,
it also appeases the paraesthesia (but also causes it, initially)
I am confident it is working very well… but can I improve on my current techniques? probably yes.
ciao, good luck with hand, Roland

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Question for today, what do you think?

When using the mirror box

  • should my weak hand not be touching anything and should I hold it up in the air so it has no touch sensation?
  • should the left hand copy the right hand movements?
  • it doesn’t matter
  • should I … Get a grip nige you are over thinking this ?
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You are not overthinking, Nige

Mirror therapy is more common in the US than the UK
I think if your weak hand experiences some sensation, yes, that will cause interference
(I put a sock or 2 on my foot to eliminate this interference)
Yes, if the left hand can copy the movements, absolutely do, it will help the illusion
It does matter ; if it’s relatively easy to achieve, go for the best illusion possible

Good luck, Roland

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