While mirror therapy is used to improve upper limb function after stroke, evidence supporting its use for treating post-stroke complex regional pain syndrome remains inconclusive. We aimed to evaluate the therapeutic effects of mirror therapy for complex regional pain syndrome after stroke. The following databases were searched for relevant literature: MEDLINE, EMCARE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, OTseeker, and the Physiotherapy Evidence Database, with no restrictions on language, type, or date. Randomized controlled trials comparing mirror therapy with placebo interventions or other treatments for stroke and complex regional pain syndrome type 1 were included. Studies involving multiple trauma cases were excluded. Primary outcomes were pain, assessed using a visual analog scale, and upper limb function, evaluated using the Wolf Motor Function Test and Fugl–Meyer assessment. Risk of bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Of 2,977 screened articles, 17 were reviewed. Three studies fulfilling the inclusion criteria with moderate overall risk of bias were considered for data extraction. All three studies assessed pain using the visual analog scale; two assessed upper extremity function via the Wolf Motor Function Test or Fugl–Meyer assessment. Each of the three studies showed significant improvement in the mirror therapy group compared with the control group. This review validated mirror therapy as an effective treatment for complex regional pain syndrome type 1 after stroke; however, the quality of evidence remains very low.

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The relationship quality between therapists and clients is crucial for obtaining a good outcome from long-term therapeutic relationships such as counseling and physical/occupational therapy. Although findings on the relationship between the compatibility of therapists and clients and their self-reported psychological characteristics/behaviors have been accumulated, it has been suggested that the compatibility of interpersonal relationships cannot be predicted by psychological constructs. Recently, using resting-state functional magnetic resonance imaging (fMRI) data and a newly developed similarity index, we overcame the limitations of self-report psychological constructs and succeeded in predicting the compatibility of interpersonal relationships a priori. We propose a procedure to predict therapist-client compatibility for better therapeutic outcomes. We hope that this tutorial note will promote the development of a prediction system and help make it more practical in the near future.

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