Saebo Mirror Box

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Saebo Mirror BoxProduct ManualNo Plateau In Sight

IntroductionSaebo is pleased to introduce a simple and effective therapy tool used to treat motordysfunction. Saebo’s Mirror Box Therapy, a treatment technique first described by V.S.Ramachandran for phantom limb pain following amputation, is a form of motor imageryin which a mirror is used to process visual feedback about motor performance of theunaffected body part as it performs various movements. It is primarily used to speed upand improve motor function after stroke and other neurological disorders.How Does It Work?Mirror therapy is based on evidence that observation activates the same motor areas ofthe brain as execution. During mirror therapy, clients place their affected arm and handinside the mirror box (to block their view of the affected side) and their unaffected handand forearm in front of the mirror. See Figure 1.The client is then directed to performa movement with their unaffectedhand and to simultaneously attemptto copy the movement with theirhidden affected hand. The clientshould be looking at the image in themirror while attempting to movethe affected hand.When looking into the mirror, theclient observes the reflection of theunaffected limb positioned as theaffected limb. This creates theillusion that both limbs are workingFigure 1normally. For example, if you putyour left hand behind a mirror and right hand in front, you can trick your brain intobelieving that the reflection of your right hand in the mirror is your left. You are nowexercising your left hand in the brain. It is believed that this strong visual cue from themirror can therapeutically be used to improve motor performance and the perception ofthe affected limb.Benefits Improving motor functionReducing painReducing neglectImproving sensationReduce spasticity1Saebo Mirror Box Therapy – Product Manual

Features LightweightSturdy DesignOne-handed OperationCollapsibleIndications For Use Sufficient cognitive and verbal abilities to focus at least 10 minutes on the mirrorreflection 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 towardsthe mirror image when asked to do so and keep their attention focused onthe mirror image at least for 5-10 minutes. Sufficient balance and trunk control to sit in a wheelchair or normal chairunsupported 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 therapyactivities.PrecautionsDizziness, nausea or sweating can be triggered in individual patient when observing themirror reflection. If this occurs, patients should no longer look into the mirror and focuson the unaffected limb or another point in the room.SetupSTEP 1 –Place Saebo Mirror Box flat on thetable. See Figure 2.Figure 22Saebo Mirror Box Therapy – Product Manual

Setup (continued)STEP 2 –Open the Saebo Mirror Box.See Figure 3.Figure 3STEP 3 –Grab handle and lift until a triangleis formed. See Figure 4.Figure 4STEP 4 –You are ready. See Figure 5.IMPORTANT:Before starting your first session,remove protective film coveringthe mirror.Figure 53Saebo Mirror Box Therapy – Product Manual

Setup (continued)The Saebo Mirror Box should be positioned in front of the patient’s midline, so that theaffected limb is fully covered by the mirror and the reflection of the unaffected limb iscompletely visible. When positioning the Mirror Box, it is important for the mirror imageto match the perception of the affected limb.The affected limb should bepositioned safely and comfortablybehind the mirror. If the client hassevere spasticity, prepositioning bya caregiver may be necessary andhelpful before positioning the limb.See Figure 6.IMPORTANT:Jewelry should be removed fromboth limbs in order to facilitate anintense mirror illusion. The mirrorimage has to match the perceptionof the affected limb in order tomaximize the effectiveness of theillusion.Figure 6Recommended Intensity Minimum of 30 minutes per day Minimum of 5 days per week4Saebo Mirror Box Therapy – Product Manual

Sample Hand Exercises10 Easy Exercises to try with clients suffering from neurological injuries such as stroke arelisted below. The key is to go at a slow pace and imagine the “hand in the mirror” is trulythe affected side.Exercise 1Make a fist and then open your handslowly. Repeat 3 sets of 15 reps.Exercise 2Touch your thumb to the tip of eachfinger. Repeat 3 sets of 15 reps foreach finger.5Saebo Mirror Box Therapy – Product Manual

Sample Hand Exercises (continued)Exercise 3Turn your palm up and down.Repeat 3 sets of 15 reps.Exercise 4Pretend to play the piano, pushingeach finger on the table one at atime. Continue for 2 minutes.Exercise 5Place a washcloth on the table.Wipe the table in a circular motion,back and forth, and up and down for2 minutes.6Saebo Mirror Box Therapy – Product Manual

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

Sample Hand Exercises (continued)Exercise 9Place 20 small objects (marbles,poker chips, blocks) on the table.Position a bowl next to the smallobjects. Place the small objects,one at a time, into the bowl.Repeat 3 times.Exercise 10Crawl your fingers along the mirrorin various directions (up, down,diagonally) for 2 minutes.8Saebo Mirror Box Therapy – Product Manual

Notes9Saebo Mirror Box Therapy – Product Manual

www.saebo.comRev. 1 2019

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 inger 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.

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