A Framework to Design Virtual Reality Mirror Therapy (VRMT) for Motor Rehabilitation in Post-Stroke Survivors: Dosage, Motivation, Task Difficulty, Feedback and Mechanism

The primary goal of mirror therapy is to alleviate symptoms and improve motor function and perception. It involves using a mirror to create a visual illusion that the affected limb is moving regularly and painlessly. Mirror therapy is often used in conjunction with traditional physical and occupational therapy methods and has been studied for post-stroke rehabilitation. However, mirror therapy effectiveness can vary among individuals. Virtual reality mirror therapy (VRMT) is an advanced application of mirror therapy that utilises virtual reality technology to enhance rehabilitation. While traditional mirror therapy uses a physical mirror to create the illusion of movement in the affected limb, VR mirror therapy takes advantage of immersive digital environments to provide a more engaging and customizable experience. This approach is particularly beneficial for stroke rehabilitation. The paper summarises four key design factors: e dosage, motivation, task difficulty and sensory feedback. In addition, it indicates the potential role of mirror neurons in both mirror therapy and VRMT and highlights three areas for future VRMT studies.