Saebo Mirror Box User manual

Product Manual
No Plateau In Sight®
Saebo Mirror Box

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Saebo Mirror Box Therapy – Product Manual
Saebo is pleased to introduce a simple and effective therapy tool used to treat motor
dysfunction. Saebo’s Mirror Box Therapy, a treatment technique rst described by V.S.
Ramachandran for phantom limb pain following amputation, is a form of motor imagery
in which a mirror is used to process visual feedback about motor performance of the
unaffected body part as it performs various movements. It is primarily used to speed up
and improve motor function after stroke and other neurological disorders.
Mirror therapy is based on evidence that observation activates the same motor areas of
the brain as execution. During mirror therapy, clients place their affected arm and hand
inside the mirror box (to block their view of the affected side) and their unaffected hand
and forearm in front of the mirror. See Figure 1.
The client is then directed to perform
a movement with their unaffected
hand and to simultaneously attempt
to copy the movement with their
hidden affected hand. The client
should be looking at the image in the
mirror while attempting to move
the affected hand.
When looking into the mirror, the
client observes the reection of the
unaffected limb positioned as the
affected limb. This creates the
illusion that both limbs are working
normally. For example, if you put
your left hand behind a mirror and right hand in front, you can trick your brain into
believing that the reection of your right hand in the mirror is your left. You are now
exercising your left hand in the brain. It is believed that this strong visual cue from the
mirror can therapeutically be used to improve motor performance and the perception of
the affected limb.
Introduction
How Does It Work?
 Benets
• Improving motor function
• Reducing pain
• Reducing neglect
• Improving sensation
• Reduce spasticity
Figure 1

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Saebo Mirror Box Therapy – Product Manual
Features
• Lightweight
• Sturdy Design
• One-handed Operation
• Collapsible
Indications For Use
• Sufcient cognitive and verbal abilities to focus at least 10 minutes on the mirror
reection and follow instructions.
• Must exhibit adequate vision:
• Client should see a clear image of the entire hand in the mirror.
• With visuospatial neglect, clients should be able to turn their head towards
the mirror image when asked to do so and keep their attention focused on
the mirror image at least for 5-10 minutes.
• Sufcient balance and trunk control to sit in a wheelchair or normal chair
unsupported for the duration of the treatment.
• Non-affected limb should ideally have a normal and pain-free range of motion.
Severe constraints of the non-affected limb could limit execution of mirror therapy
activities.
Precautions
Dizziness, nausea or sweating can be triggered in individual patient when observing the
mirror reection. If this occurs, patients should no longer look into the mirror and focus
on the unaffected limb or another point in the room.
Setup
STEP 1 –
Place Saebo Mirror Box at on the
table. See Figure 2.
Figure 2

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Saebo Mirror Box Therapy – Product Manual
Setup (continued)
STEP 2 –
Open the Saebo Mirror Box.
See Figure 3.
STEP 3 –
Grab handle and lift until a triangle
is formed. See Figure 4.
Figure 3
Figure 4
STEP 4 –
You are ready. See Figure 5.
IMPORTANT:
Before starting your rst session,
remove protective lm covering
the mirror.
Figure 5

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Saebo Mirror Box Therapy – Product Manual
Recommended Intensity
• Minimum of 30 minutes per day
• Minimum of 5 days per week
Setup (continued)
The Saebo Mirror Box should be positioned in front of the patient’s midline, so that the
affected limb is fully covered by the mirror and the reection of the unaffected limb is
completely visible. When positioning the Mirror Box, it is important for the mirror image
to match the perception of the affected limb.
The affected limb should be
positioned safely and comfortably
behind the mirror. If the client has
severe spasticity, prepositioning by
a caregiver may be necessary and
helpful before positioning the limb.
See Figure 6.
IMPORTANT:
Jewelry should be removed from
both limbs in order to facilitate an
intense mirror illusion. The mirror
image has to match the perception
of the affected limb in order to
maximize the effectiveness of the
illusion.
Figure 6

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Saebo Mirror Box Therapy – Product Manual
Sample Hand Exercises
10 Easy Exercises to try with clients suffering from neurological injuries such as stroke are
listed below. The key is to go at a slow pace and imagine the “hand in the mirror” is truly
the affected side.
Exercise 1
Make a st and then open your hand
slowly. Repeat 3 sets of 15 reps.
Exercise 2
Touch your thumb to the tip of each
nger. Repeat 3 sets of 15 reps for
each nger.

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Saebo Mirror Box Therapy – Product Manual
Exercise 3
Turn your palm up and down.
Repeat 3 sets of 15 reps.
Exercise 4
Pretend to play the piano, pushing
each nger on the table one at a
time. Continue for 2 minutes.
Exercise 5
Place a washcloth on the table.
Wipe the table in a circular motion,
back and forth, and up and down for
2 minutes.
Sample Hand Exercises (continued)

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Saebo Mirror Box Therapy – Product Manual
Exercise 6
Place a water bottle on the table,
grasp it with your hand, lift it up 2
inches, place it back on the table
and let go. Repeat 3 sets of 15 reps.
Exercise 7
Place 5 coins on the table. Pick them
up one at a time until they are all
in your palm. Place them back on
the table, one at a time, using your
thumb and your index and middle
ngertips. Repeat 5 times.
Exercise 8
Place a foam ball on the table.
Pick up the ball, squeeze it and place
back down on the table and let go.
Repeat 3 sets of 15 reps.
Sample Hand Exercises (continued)

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Saebo Mirror Box Therapy – Product Manual
Exercise 9
Place 20 small objects (marbles,
poker chips, blocks) on the table.
Position a bowl next to the small
objects. Place the small objects,
one at a time, into the bowl.
Repeat 3 times.
Exercise 10
Crawl your ngers along the mirror
in various directions (up, down,
diagonally) for 2 minutes.
Sample Hand Exercises (continued)