Effects of Modified Constraint-Induced Movement Therapy and Mirror Therapy in Hemiplegic Stroke

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• * Uncontrolled diabetes or other metabolic disorders.
  • Progressive non-stroke neurological diseases (e.g., Parkinson's disease, multiple sclerosis).
  • Terminal illness or short life expectancy.
  • Severe cognitive impairment preventing comprehension or execution of the study protocols (e.g., advanced dementia).
  • Severe visual impairment that prevents mirror therapy application (e.g., uncorrected visual acuity loss, neglect).
  • Severe visuospatial perception disorders making it difficult to perceive or interpret the mirror image.
  • Absence or minimal level of active movement in the affected upper extremity (limiting the applicability of modified CIMT).
  • Significant motor deficit in the unaffected upper extremity.
  • Severe and uncontrolled spasticity in the upper extremity.

• * Diagnosis: Confirmed first ischemic or hemorrhagic stroke with clinical and neurological evaluation.
  • Time Since Stroke: 3 to 24 months post-stroke onset.
  • Hemiplegia: Significant motor deficit in the affected upper extremity.
  • Motor Function Level: Presence of mild to moderate motor impairment in the affected upper extremity (FMA-UE score appropriate for the application of modified CIMT and mirror therapy).
  • Cognitive Status: Adequate cognitive capacity to understand and follow the study protocols (Mini-Mental State Examination score of 20 or above).
  • Visual Perception: Adequate visual perception to perform mirror therapy.
  • Comorbidities: Absence of severe coexisting medical conditions that prevent participation (e.g., uncontrolled cardiovascular diseases, severe psychiatric disorders).
  • Prior Treatments: No prior intensive participation in the interventions investigated in this study (modified CIMT or mirror therapy).
  • Consent: Voluntary agreement to participate and signed informed consent form.