Effect of Mirror Therapy for Patients With Shoulder Pain: A Scoping Review

IntroductionMirror therapy has demonstrated functional benefits for patients recovering from hemiparetic stroke, with its effectiveness primarily attributed to the induction of a compelling visual illusion that engages sensorimotor networks. Although previous research has identified various intervention parameters influencing therapeutic outcomes, a comprehensive understanding of their effects on the illusory experience remains limited. This study investigated how four critical parameters—mirror size (large vs. small), object manipulation (present vs. absent), task complexity (simple vs. complex), and movement execution (unilateral vs. bilateral)—modulate the believability of the mirror illusion in neurologically unimpaired individuals.MethodsForty healthy participants performed movements under 16 different combinations of these parameters while receiving mirror visual feedback and rated the believability of the reflected hand on an 11-point Likert scale.ResultsRepeated-measures ANOVA revealed that a large mirror consistently enhanced the illusory experience compared to a small mirror. Although bimanual movements generally resulted in higher believability ratings than unimanual movements, this advantage diminished when complex object manipulation tasks were introduced.DiscussionThese findings suggest that the congruency of multisensory information—between visual, proprioceptive, and motor signals—is critical for maximising the strength of the illusory experience. By identifying the optimal conditions for enhancing the mirror illusion in healthy individuals, this study establishes a foundational framework for adapting and refining mirror therapy protocols in clinical populations.

BackgroundAround 80% of stroke survivors experience upper-limb impairment during the acute phase, with 55% to 75% still affected after 6 months, hindering their daily activities. Consequently, upper-limb rehabilitation has become essential in post-stroke management, leading to innovative therapeutic methods. Despite the variety of available techniques, Mirror Therapy stands out as a feasible and cost-effective option alongside conventional physical therapy. This study aims to assess the impact of Mirror Therapy on improving motor and timed functional abilities of the upper extremities in chronic stroke patients in Saudi Arabia.MethodologyThis study was a prospective, randomized controlled trial, which was conducted at 3 Ministry of Health hospitals in Saudi Arabia with 38 chronic stroke patients randomly assigned into two treatment arms, experimental group (n = 19) and control group (n = 19). The study was registered in clinicaltrails.gov with the registration ID NCT06698380. The experimental group received 45 min of training three days a week for six weeks. The Fugl-Meyer Assessment Upper Extremity (FMA-UE) and Wolf Motor Function S Test (WMFT) were used as outcome measures. Pre- and post-intervention measurements were obtained.ResultsThe participants' average age was 54.97 ± 7.11 years, with an average height of 165.66 ± 11.21 cm, weight of 78.92 ± 18.96 kg, and BMI of 28.71 ± 6.19 kg/m². Among them, the majority of participants were male (68.4%), with ischemic strokes being the most prevalent type (73.7%). The FMA-US and WMFT scores showed significant improvement in the experimental group (p < 0.001) when compared to the control group.ConclusionMirror Therapy significantly enhances motor ability and timed functional activities in the upper extremity of chronic stroke patients.

BackgroundFinger spasticity, which worsens hand function, is common in stroke patients. Botulinum toxin A (BoNT-A) treatment is effective in relieving spasticity but has little effect on arm-hand capacity. The adding of a rehabilitation program following BoNT-A injection has been suggested to enhance spasticity treatment outcomes. This pilot study aimed to compare the effects of BoNT-A combing with robot-assisted bimanual therapy (RBT) versus BoNT-A combing with RBT integrating mirror therapy (RBMT) in patients with chronic stroke and spastic fingers.MethodsPatients with chronic stroke and finger spasticity were recruited. They were randomly allocated to receive 24 training sessions of RBT or RBMT. Assessments were performed before BoNT-A injection, after 24 training sessions, and 3 months follow-up. The outcomes included Fugl-Meyer assessment for the upper extremity (FMA-UE-total, proximal and distal component scores), modified Ashworth scale (MAS), action research arm test (ARAT), box and block test (BBT), and motor activity log (MAL). We applied Friedman’s test to analysis intragroup, generalized estimating equations for intergroup differences of the treatment effects.ResultsThirty-one patients were randomly allocated to the RBMT (n = 16) and RBT (n = 15) groups. After BoNT-A injection and training, both groups showed statistically significant improvements in FMA-UE total and FMA-proximal, MAS, and ARAT scores. Only the RBMT group showed significant improvements in the FMA-UE distal, and MAL scores. Neither group showed a significant improvement in the BBT. In the RBMT group the injection and post-training gains were maintained at the 3-month follow-up, except for MAS. The RBT group did not show a maintenance effect, except for the amount of use the affected UE, which showed significant improvement from baseline to follow-up. Comparing the treating effects between the two groups, there were significant differences in the FMA distal scores at post-training, favoring RBMT.ConclusionsOur pilot data demonstrated that an adjunct to BoNT-A for post-stroke spastic fingers, RBMT may provide more benefit in distal UE function than did RBT. However, a larger sample size and adding a proper control group are required to validate our findings in future studies.Trial registration This study was registered at ClinicalTrials.gov (ID no. NCT04826900, registered retrospectively on 03/28/2021).

Ischemic stroke occurs when a thrombus, embolus, or vascular stenosis disrupts blood supply to the brain, causing vessel rupture and blood leakage into the surrounding neuronal space. A common clinical symptom of stroke is hemiparesis, or muscle weakness on one side of the body. Non-pharmacological management, such as range of motion exercises using mirror therapy, can support rehabilitation. Mirror therapy is a form of motor rehabilitation that engages the patient's motor imagery. The mirror provides visual stimulation to the brain, particularly the cerebral motor nerves on both the affected and unaffected sides, to assist movement in limbs experiencing hemiparesis. This study used a case study method, implementing nursing care and evidence-based nursing practice. Over six consecutive days of intervention, mirror therapy led to increased muscle strength. Prior to the therapy, muscle strength was recorded at. After the therapy, muscle strength improved to. These results suggest that mirror therapy can serve as an effective rehabilitation strategy to address impaired physical mobility in patients with ischemic stroke.

Background: Stroke generally leads to substantial impairment of fine motor function, particularly in the upper limbs, impairing independence and quality of life. Mirror Box Therapy and Constraint-Induced Movement Therapy (CIMT) are two cutting-edge rehabilitation methods that use neuroplasticity to improve motor recovery. By limiting the unaffected side, CIMT encourages functional use of the affected limb, whereas Mirror Box Therapy uses visual feedback to encourage motor imagery and cortical reorganization. This study investigates the feasibility and combined effects of CIMT and Mirror Box Therapy in improving fine motor function in stroke patients.Methods: The study was conducted with 20 participants of population in post MCA stroke patients aPrivateMedical College and hospital, Chennai using random sampling technique based on inclusion and exclusion criteria. The study was explained to the subjects and the written consent was obtained from the subjects. The participants were split into two groups, Group A- 10 and Group B- 10. Group A was treated with CIMT and task -oriented training. Group B was treated with mirror box therapy and task -oriented training. Conclusion-Cimt: Group showed substantial difference in improving fine motor activities in contrast to Mirror Box group, post-test values of CIMT group in Fugl Meyer Upper Extremity scale value where the p value is &lt; 0.0001. The investigation finds that Constraint-induced movement therapy along with task -oriented training was effective in improving fine motor activities among the geriatric stroke patients.

BackgroundInterventions for unilateral neglect have involved various approaches, notably the integration of robotics into clinical practice.ObjectiveThis study examined the effects of Robotic Mirroring Training (RMTr) and Mirror Therapy with Robot (MTh-R) on unilateral neglect, activities of daily living (ADL), and depression, and compared the effectiveness of the two interventions.MethodsThis study was a randomized controlled trial. Twenty-four patients with subacute stroke were randomly assigned to either the RMTr group (n = 12) or the MTh-R group (n = 12). Both groups received 30-min sessions, three times per week for five weeks, using the same robotic glove (SY-HRE12, SYREBO): the mirroring function for the RMTr group and pre-programmed passive movements for the MTh-R group. Unilateral neglect was assessed using the Behavioral Inattention Test-Conventional (BIT-C) and the Korean Catherine Bergego Scale (K-CBS). ADLs were measured with the Korean version of the Modified Barthel Index (K-MBI), and depression was assessed using the Korean Short Form Geriatric Depression Scale (SGDS-K). Pre- and post-intervention scores and between-group differences were analyzed.ResultsBoth groups showed significant improvements in BIT-C and K-CBS scores (p < 0.01). The RMTr group demonstrated statistically significant improvements in K-MBI (p < 0.01) and SGDS-K (p < 0.01), while the MTh-R group showed significant improvements in K-MBI (p < 0.05) and SGDS-K (p < 0.01). These results indicate reduced unilateral neglect, enhanced ADL performance, and decreased depression in both groups. Significant between-group differences were observed in BIT-C (p < 0.01), K-CBS, and SGDS-K (p < 0.05), confirming the greater overall effectiveness of the interventions.ConclusionsWhile both interventions were effective, RMTr demonstrated greater efficacy in reducing unilateral neglect and depression.

Effectiveness of mirror therapy to treat musculoskeletal injuries of the hand and wrist: A systematic review.

IntroductionChronic low back pain (CLBP) is a prevalent global condition that significantly impairs quality of life, reduces work productivity and imposes substantial healthcare burdens. Approximately 70% of adults worldwide experience at least one episode of low back pain during their lifetime. Central sensitisation, a common complexity of CLBP, involves heightened responsiveness of the central nervous system, resulting in amplified neural signalling and increased pain sensitivity. This phenomenon suggests that pain in CLBP extends beyond purely biomedical origins, involving multiple factors such as neural adaptation. Graded Motor Imagery (GMI) is a progressive, exercise-based therapeutic approach designed to retrain the brain’s representation of the body and has shown promise in managing pain associated with central sensitisation.Methods and analysisThis randomised controlled trial aims to assess the efficacy of remote GMI therapy compared with conventional in-clinic therapy in CLBP patients exhibiting pain sensitisation. Adults aged 20–50 years with persistent low back pain for at least 6 months will be included. Exclusion criteria comprise significant spinal pathology, recent spinal surgery, severe mental disorders, other major chronic pain conditions, high baseline pain levels (Visual Analogue Scale, VAS >7), neurological motor disorders and pregnancy. Eligible participants will be randomised into either an online therapy group or a control group. The online therapy group will engage in GMI exercises using the ‘Recognise’ app, encompassing tasks such as left/right discrimination, explicit motor imagery and mirror therapy, performed twice daily for 10 min each. The control group will participate in equivalent exercises supervised by a physical therapist, employing physical aids for cognitive tasks and mirror therapy. Both groups will undergo an intensive 6-week therapy phase followed by a 6-month maintenance phase involving weekly sessions to reinforce progress and prevent relapse. Primary outcomes, including pain intensity (VAS) and functional disability (Oswestry Disability Index), alongside secondary measures of pain sensitivity and quality of life, will be assessed at baseline and at 3-month and 6-month follow-ups.Ethics and disseminationThe study protocol has been approved by the Shanghai University of Sport Scientific Research Ethics Committee. Written informed consent will be obtained from all participants. Study results will be disseminated through publications in international peer-reviewed journals and presentations at academic conferences.Trial registration numberChiCTR2400084205.

IntroductionUpper limb motor dysfunction after stroke is a leading cause of disability worldwide, resulting in a significant economic burden on society. Rehabilitation is a key strategy for improving this condition. Although studies have shown that digital mirror therapy and repetitive peripheral magnetic stimulation individually provide benefits, the effectiveness of their combination remains unclear. We are conducting a randomised controlled trial to evaluate the efficacy of combining digital mirror therapy with repetitive peripheral magnetic stimulation in treating upper limb motor dysfunction post-stroke, in order to meet the urgent clinical need for more effective treatment options.Methods and analysisThis is a single-blind randomised controlled trial. A total of 46 participants will be randomly assigned in a 1:1 ratio to either the digital mirror therapy combined with repetitive peripheral magnetic stimulation group or the repetitive peripheral magnetic stimulation group. Both groups will undergo the intervention protocol spanning four consecutive weeks. Assessments will be conducted at baseline and after 4 weeks of treatment. The primary outcome will be evaluated using the Fugl-Meyer Assessment for Upper Extremity score. Secondary outcomes include the Action Research Arm Test, Box and Block Test, Modified Barthel Index, Fugl-Meyer Assessment - Upper Extremity Sensory subscale, Modified Ashworth Scale, as well as pinch strength, grip strength and adverse events. Intention-to-treat analysis will be applied to all data, including missing or dropout data.Ethics and disseminationThe study was approved by the Ethics Committee of Quanzhou First Hospital on 23 September 2024 (2024K193). The final results of this study will be published in a peer-reviewed journal.Trial registration numberChiCTR2400092692.

Robot-assisted mirror therapy (MRT) is a cutting-edge rehabilitative treatment that combines mirror therapy and rehabilitation robots and can improve stroke patient participation in rehabilitation training. The aim of this study was to investigate the effects of MRT training in patients with right-hemisphere damage (RHD). Fifty-three RHD patients were randomly assigned to the MRT (N = 17), passive movement (PM) (N = 19), or functional occupational therapy (FOT) group (N = 17) for 4 weeks of training. All three groups received conventional medication and rehabilitation therapy, along with 20 min of FOT. In addition, the MRT group underwent 10 min of MRT, the PM group received 10 min of PM training, and the FOT group underwent 10 min of additional FOT. Upper-limb motor function was evaluated by the Fugl–Meyer Assessment–Upper Extremity (FMA-UE) and the Fugl–Meyer Assessment–Wrist and Hand (FMA-WH) before and after treatment. The daily life activities of the patients were evaluated with the modified Barthel index (MBI). Cortical activation was evaluated by functional near-infrared spectroscopy (fNIRS). Compared with the PM and FOT methods, the MRT method more effectively improved the FMA-UE score, FMA-WH score and MBI. In addition, MRT is expected to improve cortical activation in patients.

The purpose of this systematic review is to explore strategies for preventing phantom limb pain in amputated patients. Given the complex mechanisms of peripheral and central sensitization underlying phantom limb pain and the limited effectiveness of current pharmacological and non-pharmacological treatments, prevention is critical to reducing its impact on patients' quality of life and treatment burden. Through a comprehensive search from four databases about the prevention of phantom limb pain, 1781 articles published between 2014 and 2024 were identified. Human studies that measured the association between preventive methods for phantom limb pain were considered eligible. The inclusion criteria of the literature were (1) prevention/ prophylactic treatment of phantom limb pain among amputees, (2) publication within the last 10 years, (3) randomized controlled trial or cohort, and (4) study written in English. Animal studies were excluded from this analysis. Four randomized controlled trials and one cohort were included in this study. To prevent phantom limb pain, various approaches can be taken, both operative and non-operative. Surgery involving a combination of peripheral nerve coaptation, collagen nerve wrapping, and submuscular transposition, when compared to neurectomy alone, has demonstrated satisfactory results. In the non-surgical method, the administration of dexmedetomidine and calcitonin as an epidural injection, oral gabapentin, and mirror therapy gave good results. A preventive approach to phantom limb pain, in terms of surgical and non-surgical methods, might reduce the incidence of phantom limb pain and increase the quality of life among amputees.

Background: Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that usually affects a limb following injury or surgery and is characterized by severe pain accompanied by sensory, motor, autonomic, and trophic disturbances. Methods: This systematic review aimed to synthesize the available evidence on the effectiveness of physical exercise and neurocognitive interventions grounded in cognitive-behavioral therapy (CBT) principles for the management of CRPS. A comprehensive search was conducted in Medline (via Ovid), LILACS, ScienceDirect, PEDro, OTseeker, and the Cochrane Central Register of Controlled Trials (CENTRAL). Eligible studies included clinical trials, cohort studies, and cross-sectional studies, whereas case reports, pediatric populations, and animal studies were excluded. Fifteen studies met the inclusion criteria. Results: The findings indicated that aerobic exercise was consistently associated with pain reduction and functional improvement. Neurocognitive interventions informed by CBT principles, such as mirror therapy and graded exposure, also demonstrated efficacy in decreasing pain and enhancing functional independence. Most studies supported the effectiveness of these approaches in the management of CRPS. Overall, both physical exercise and neurocognitive interventions grounded in CBT principles produced positive effects on pain modulation, physical function, and daily activity performance. Conclusions: These findings highlight the therapeutic potential of combining physical and psychologically informed interventions for the treatment of CRPS.

Introduction. Phantom limb pain is a common complication after limb amputation, involving cortical reorganization and disturbed sensorimotor integration. Mirror therapy (MT), a non-invasive method using the illusion of the amputated limb, is applied to reduce pain. Aim. To present the case of a young woman after traumatic upper limb amputation, treated with mirror therapy for phantom limb pain. The report emphasizes the progression of therapy and the psychosocial aspects of rehabilitation. Case report. A 34-year-old woman, after left forearm amputation, experienced phantom pain (VAS 5–6/10) and non-painful phantom sensations. MT was applied daily in 2–3 sessions of 20 minutes. Gradual improvement in muscle tone and phantom perception was noted. Coexisting depressive and anxiety symptoms required psychological support. Results. Mirror therapy led to a marked reduction of phantom pain and improved functional body image. The patient gradually adapted to the new situation. Conclusions. Mirror therapy shows potential as an effective intervention in phantom limb pain management after upper limb amputation. The key to success is a comprehensive approach combining physical rehabilitation and psychological support.

To address the limitations of traditional mirror therapy in stroke rehabilitation, such as rigid movement mapping and insufficient personalization, this study proposes a robot-assisted mirror rehabilitation framework integrating multimodal biofeedback. By synchronously capturing kinematic features of the unaffected upper limb and surface electromyography (sEMG) signals from the affected limb, a dual-modal feature fusion network based on a cross-attention mechanism is developed. This network dynamically generates a time-varying mirror ratio coefficient , which is incorporated into the exoskeleton’s admittance control loop. Combining a trajectory generation algorithm based on dynamic movement primitives (DMPs) with a compliant control strategy incorporating dynamic constraints, the system achieves personalized rehabilitation trajectory planning and safe interaction. Experimental results demonstrate that, compared to traditional mirror therapy, the proposed system exhibits superior performance in bilateral trajectory covariance metrics, the mirror symmetry index, and muscle activation levels.

Background: Stroke is a global health problem that is the second commonest cause of death and fourth leading cause of disability worldwide. Both motor relearning programme and mirror therapy helps to improve upper extremity functions in post stroke patients. The aim of the study is to compare the effectiveness of motor relearning programme against mirror therapy on upper extremity functions in post stroke patients. Materials and Methods: Post stroke 30 patients with upper limb disability were selected by convenient sampling method based on inclusion and exclusion criteria and then assigned into two groups, group A and group B. Group A (motor relearning programme group) received motor relearning programme; whereas group B (mirror therapy group) received mirror therapy for 4 weeks. Outcome Measures: The Fugl Meyer Assessment of Physical Performance of Upper Extremity (FMA-UE) scale and Chedoke Arm And Hand Activity Inventory Scale (CAHAI) were used to evaluate and compare the effectiveness of motor relearning programme and mirror therapy on upper extremity functions in post stroke patients, at 1st day and at the end of 4th week. Intervention values for upper extremity functions were measured before and after treatment. Results: Statistical analysis done by using paired ‘t’-test and independent ‘t’ test showed that there was significantly improvement in subjects who received motor relearning programme. Paired ‘t’ test revealed upper extremity functions in post stroke patients were improved significantly in group A after applying motor relearning programme for 4 weeks i.e. (p=7.73815×10-11 in FMAUE scale) and (p=8.47303×10-11 in CAHAI scale). Paired ‘t’ test also revealed upper extremity functions in post stroke patients was improved significantly in group B after applying mirror therapy for 4 weeks i.e. (p=4.27209×10-7 in FMA-UE scale) and (p=2.77828×10-7 in CAHAI scale). Independent ‘t’ test revealed upper extremity functions in post stroke patients was extremely significant in group-A after applying motor relearning programme i.e. (p=1.08411×1015 in FMA-UE scale) and (p=1.56334×10-15 in CAHAI scale). So when compared within the groups, motor relearning programme and mirror therapy were effective in improving upper extremity functions. But when compared between the groups, motor relearning programme was found to be extremely significant for improving upper extremity functions in post stroke patients. Conclusion: In light of the study’s findings, it is concluded that the motor relearning programme is more effective and extremely significant in improving upper extremity functions in post stroke patients as compared to mirror therapy

Phantom pain (PP) is a neuropathic pain syndrome that occurs after limb amputation and is perceived in the absent body part. Its exact pathophysiology remains unclear but involves peripheral nerve lesions, central sensitization, and cortical reorganization. Psychological and social factors also play a significant role in its manifestation. Phantom pain after amputation shows wide variability, affecting up to 82% of patients within the first postoperative year, with lifetime prevalence exceeding 80%, and higher rates observed after proximal or major amputations (e.g., transfemoral). Symptoms are typically described as intermittent, burning, or electric-like pain, often accompanied by non-painful phantom sensations. Diagnosis requires thorough neurological evaluation, detailed pain documentation, and the exclusion of differential diagnoses. Preventive strategies include perioperative nerve blocks and adequate surgical soft tissue coverage. Effective treatment is based on a multimodal approach. Pharmacological options such as morphine and pregabalin have shown efficacy, while others like tramadol or gabapentin appear less effective. Non-pharmacological methods - including mirror therapy and transcutaneous electrical nerve stimulation (TENS) - can support pain relief. Psychological interventions, particularly trauma-focused therapy, may be beneficial, especially in patients with post-traumatic stress symptoms. For optimal management, an individualized treatment plan combining pharmacological, physical, and psychological strategies is recommended.

This study aimed to compare the long-term effects of soft robotic gloves (SRGs) and mirror therapy on hand function and motor recovery in post-stroke patients. A single-blinded, randomized controlled comparative study was conducted on 49 patients with chronic stroke assigned randomly to either the SRGs or mirror therapy group. Both groups underwent an 8-week intervention alongside conventional rehabilitation. The Box and Block Test (BBT), hand grip strength, and Fugl-Meyer Assessment-Upper Extremity (FMA-UE), were assessed at baseline, post-intervention, and 6-month follow-up. Post-intervention, the SRGs group demonstrated significantly greater improvements in all outcome measures compared with the mirror therapy group (p = 0.004, 0.011, and 0.021, respectively). These improvements were sustained at follow-up (p < 0.001, < 0.001, and 0.003, respectively). Within-group comparisons showed significant post-intervention improvements in both groups; however, the mirror therapy group exhibited no significant changes between post-intervention and follow-up (p = 0.197, 0.125, and 0.317, respectively), whereas the SRGs group maintained significant gains (p = 0.003, 0.012, and 0.005, respectively). Findings suggest that SRGs provide superior improvements in hand function and motor recovery compared with mirror therapy in post-stroke rehabilitation. The long-term benefits highlight the potential of SRGs as an effective intervention for promoting functional independence in stroke survivors.

IntroductionCerebral stroke often results in significant motor deficits, including contralateral hemiparesis of the upper limb. Rehabilitation protocols with high-intensity and task-specific exercises can improve these deficits. Recent technological advancements in virtual reality (VR), myoelectric control, and exergames may be exploited to enhance rehabilitation effectiveness. However, novel rehabilitation approaches combining these novel methodologies have rarely been developed with the active involvement of both therapists and patients.MethodsAn interdisciplinary team developed a novel system, Validation of the Virtual Therapy Arm (VVITA), for post-stroke upper-limb rehabilitation combining VR, myoelectric control, and exergames using a user-centered design (UCD) approach. The VVITA hardware includes a head-mounted VR display, motion tracking devices integrated in the VR system, and wireless armbands to record electromyographic (EMG) signals, providing an interactive virtual environment for immersive rehabilitation exercises implementing a virtual mirror therapy. Assistance and task difficulty are adjusted dynamically based on patient performance, promoting active participation and motor learning.ResultsThe development process involved iterative phases, involving focus groups with stroke patients, therapists, and researchers. A pilot study with four stroke survivors assessed the system’s feasibility, demonstrating its potential for personalized and adaptive rehabilitation.ConclusionThe VVITA system enhances mirror therapy by integrating VR and myoelectric control, providing a tailored approach to upper-limb post-stroke rehabilitation. The UCD approach ensured the system met patient and therapist needs, showing promise for improving motor recovery and rehabilitation outcomes.

Hand trauma is common, and can be functionally limiting and psychologically distressing. Hand dysfunction that is persistent after trauma can be troublesome to manage. Patient-reported outcome measures (PROMs) are useful in assessing hand function, and an improvement has been associated with an increase in health-related quality of life. Hand therapy is important for managing patients with residual poor hand function after trauma, but minimal evidence exists to support commonly used treatments. This review aimed to evaluate the evidence for interventions, outcome measures, and the implications for future research in hand therapy. A systematic review with narrative synthesis was conducted. Randomised controlled trials of residual hand dysfunction after trauma were included. The primary outcome measures were PROMs validated in hand trauma. Secondary outcomes included symptoms of hand dysfunction or validated tests that evaluate hand function. 19 studies were included. Occupation-based interventions showed moderate strength of effect in improving hand function in terms of PROMs. Mirror therapy, robot-aided rehabilitation, orthotic management of the stiff hand, and oedema-reducing therapies were also evaluated. The findings were limited by a high risk of bias and lack of robust methodology in the included studies. PROMs were inconsistently utilised, along with a variety of other outcome measures. No firm recommendations for practice can be made based on the evidence included in this review. Well designed, multicentre trials are needed to generate more robust evidence. Standardisation of outcome measures and reporting, and the use of PROMs aligned with patient priorities will be crucial for advancing research in hand therapy.