How To Make A Mirror Box Therapy

How To Make A Mirror Box for Mirror Box Therapy

Mirror box therapy is a therapeutic technique utilized primarily for the rehabilitation of motor function and pain management, particularly following stroke, phantom limb pain, and complex regional pain syndrome (CRPS). The technique involves using a mirror placed vertically between a patient’s arms or legs. The reflection of the unaffected limb creates a visual illusion of the affected limb moving normally. This visual feedback can help to “trick” the brain, thereby alleviating pain and improving motor control.

While professionally-made mirror boxes are available for purchase, constructing a mirror box at home or in a clinical setting offers a cost-effective alternative. A homemade mirror box can be customized to suit the specific needs and physical limitations of the patient, making it a versatile tool for rehabilitation. This article provides a detailed, step-by-step guide on how to build a functional and effective mirror box for therapeutic use.

Key Point 1: Gathering the Necessary Materials and Tools

The first step in constructing a mirror box is assembling the required materials and tools. The selection of materials influences the durability, stability, and overall effectiveness of the mirror box. Careful consideration should be given to the dimensions and structural integrity of the box to ensure it can withstand regular use and provide adequate visual feedback. Here's a breakdown of what you will need:

1. Wood or Sturdy Cardboard: The primary material for the box structure. Wood offers greater durability and stability, especially for long-term use. Plywood, MDF (Medium-Density Fiberboard), or even thick, strong cardboard can be suitable options. Consider the thickness of the material; ideally, it should be at least 1/4 inch (6mm) thick for wood and several layers for cardboard to prevent warping or collapsing. The amount of material needed will depend on the desired size of the box. Estimate the following dimensions and then adjust them to suit the patient's needs:

Width: Approximately 24 inches to 30 inches (60-75 cm) to accommodate both arms comfortably.
Depth: Approximately 12 inches to 18 inches (30-45 cm), sufficient to allow for arm movement without obstruction.
Height: Approximately 12 inches to 18 inches (30-45 cm), ensuring adequate space for viewing the reflection.

2. Mirror: The core component of the mirror box. Select a glass mirror of appropriate size and thickness. A mirror approximately 12 inches wide and 12 inches high is typically adequate, but adjust to suit the box dimensions. Ensure the mirror's edges are smooth to prevent cuts or injuries. Safety mirrors made of acrylic are a suitable alternative to glass, offering impact resistance and reduced risk of shattering.

3. Cutting Tools: A saw (hand saw, jigsaw, or circular saw) is necessary for cutting the wood or cardboard to the desired dimensions. For cardboard, a utility knife or sturdy scissors can be used. A metal ruler or straight edge is essential for accurate and precise cuts.

4. Fastening Materials: Depending on the chosen material, use appropriate fasteners to assemble the box structure. For wood, wood screws, nails, or wood glue are suitable. For cardboard, strong adhesive tape (e.g., duct tape or packing tape) or glue is required. Clamps or weights may be helpful in holding the pieces together while the adhesive dries.

5. Measuring and Marking Tools: A measuring tape, ruler, and pencil are essential for accurate measurement and marking of the wood or cardboard before cutting. A square can be used to ensure right angles for a more stable and professional-looking box.

6. Safety Gear: When working with cutting tools and adhesives, appropriate safety gear is crucial. Safety glasses protect the eyes from debris, and gloves protect the hands from splinters, cuts, or adhesive contact. A dust mask is recommended when working with wood to prevent inhalation of sawdust.

7. Optional Materials:

Sandpaper: For smoothing any rough edges of the wood or cardboard.
Paint or Varnish: For sealing and finishing the wood to protect it from moisture and wear. Paint can also enhance the aesthetic appeal of the mirror box.
Padding: Foam padding or fabric can be added to the arm rests for increased comfort during therapy sessions.

Key Point 2: Assembling the Mirror Box Structure

Once you have gathered all the necessary materials and tools, the next step is to assemble the mirror box structure. Accuracy in cutting and assembly is critical for creating a stable and functional box. This section provides detailed instructions for constructing the box from both wood and cardboard.

A. Wood Construction:

1. Cutting the Wood: Measure and mark the wood according to the following dimensions (adjust these to fit the patient). You will need six pieces:

Top: One piece (24-30 inches wide x 12-18 inches deep)
Bottom: One piece (24-30 inches wide x 12-18 inches deep)
Sides: Two pieces (12-18 inches high x 12-18 inches deep)
Front: One piece (24-30 inches wide x 12-18 inches high)
Mirror Support: One piece (12 inches wide x 12 inches high)

Use a saw to cut the wood pieces along the marked lines. Ensure the cuts are straight and precise. Sand the edges of each piece to remove any splinters and create a smooth surface. Consider leaving an opening in the front of the box for enhanced visibility and ease of access for the hands/arms.

2. Assembling the Box: Begin by attaching the side pieces to the bottom piece. Use wood screws, nails, or wood glue to secure the pieces together. If using glue, apply it liberally to the edges and use clamps to hold the pieces in place until the glue dries completely. Next, attach the top piece to the sides and bottom, again using screws, nails, or glue. Ensure all corners are square for structural integrity. Finally, attach the front piece, leaving an opening towards the top for visibility and mirror support.

3. Installing the Mirror: The mirror is inserted into the box through the front opening so that it divides the box into two compartments.. Secure the mirror in place using small strips of wood or metal brackets attached to the inside of the box. Ensure the mirror is firmly fixed and does not wobble. The Mirror Support piece is then secured on the floor of the box to keep the mirror upright.

4. Finishing (Optional): Paint or varnish the exterior of the mirror box to protect the wood and enhance its appearance. Allow the paint or varnish to dry completely before using the box.

B. Cardboard Construction:

1. Cutting the Cardboard: Measure and mark the cardboard according to the dimensions listed above for the wood construction. Use a utility knife or sturdy scissors to cut the cardboard pieces along the marked lines. Ensure the cuts are clean and straight. Reinforce the edges of the cardboard pieces with tape to prevent tearing or bending.

2. Assembling the Box: Assemble the cardboard box using strong adhesive tape. Start by attaching the side pieces to the bottom piece, taping them securely along all edges. Reinforce the corners with multiple layers of tape for added stability. Next, attach the top piece to the sides and bottom, again using tape. Ensure all corners are square and well-secured. Finally, attach the front piece, leaving an opening towards the top for inserting the mirror.

3. Installing the Mirror: Insert the mirror into the box through the front opening so that it divides the box into two compartments. Secure the mirror in place using tape. Attach tape strips to the edges of the mirror and adhere them to the inside of the box. Reinforce the mirror’s position with additional tape, ensuring it is stable and does not move. The Mirror Support piece is then secured on the floor of the box to keep the mirror upright.

4. Reinforcing (Optional): Reinforce the entire cardboard box with additional layers of tape. Wrap tape around the edges and corners to provide extra support and prevent the box from collapsing. Consider covering the cardboard with decorative paper or fabric to improve its appearance.

Key Point 3: Customization and Safety Considerations

Once the basic mirror box structure is assembled, consider customizing it to meet the specific needs and preferences of the patient. Customization can enhance comfort, improve functionality, and increase the overall effectiveness of the therapy. Prioritize safety throughout the construction and customization process to prevent injuries and ensure a secure therapeutic environment.

A. Customization Options:

1. Adjustable Height: Implement a mechanism that allows for adjusting the height of the mirror box. This can be achieved through adjustable legs or risers, enabling the box to accommodate patients of different heights. Proper height adjustment ensures optimal viewing angles and reduces strain on the neck and shoulders.

2. Arm Rests: Add padded arm rests to the box structure. These arm rests provide support and comfort for the arms during therapy sessions, reducing fatigue and promoting relaxation. Use foam padding or fabric-covered cushions for arm rests, attaching them securely to the inside of the box.

3. Hand Openings: Incorporate hand openings in the sides of the box to allow for easier access and manipulation of objects during therapy. Cut circular or oval openings in the sides of the box, ensuring they are large enough to accommodate the patient’s hands comfortably. Smooth the edges of the openings to prevent cuts or scrapes. Consider adding fabric cuffs or sleeves to the openings to prevent light from entering the box.

4. Viewing Angle Adjustment: Design a system that allows for adjusting the angle of the mirror. This can be achieved through hinges or adjustable brackets, enabling the therapist to optimize the visual feedback based on the patient’s specific needs. Proper angle adjustment enhances the illusion of normal movement and improves the therapeutic effect.

5. Portable Design: Create a lightweight and portable mirror box that can be easily transported and used in different locations. Use lightweight materials, such as thin plywood or sturdy cardboard, and incorporate a carrying handle or strap. A portable mirror box allows patients to continue therapy at home or in other convenient settings.

B. Safety Considerations:

1. Mirror Safety: Use safety glass or acrylic mirrors to minimize the risk of shattering and potential injuries. Ensure the edges of the mirror are smooth and protected to prevent cuts or scrapes. Secure the mirror firmly within the box structure to prevent it from falling or moving during use.

2. Material Safety: Select non-toxic materials for constructing the mirror box. Avoid using materials that emit harmful fumes or chemicals. Ensure any paints, adhesives, or finishes are certified as safe for human contact.

3. Structural Stability: Build the mirror box with a stable and sturdy structure to prevent it from tipping over or collapsing. Reinforce the corners and edges of the box to ensure it can withstand regular use. Test the stability of the box before using it with patients.

4. Edge Protection: Smooth and protect all edges and corners of the mirror box to prevent cuts or scrapes. Use sandpaper to smooth rough edges or apply edge banding to cover sharp corners. Consider adding rubber bumpers to the bottom of the box to prevent it from scratching surfaces.

5. Proper Supervision: Always supervise patients during mirror box therapy sessions to ensure they are using the box safely and effectively. Provide clear instructions on how to use the box and monitor their progress. Be prepared to provide assistance or make adjustments as needed.

By carefully gathering the necessary materials, assembling the mirror box structure, and customizing it to meet specific needs while prioritizing safety, individuals can create a valuable tool for mirror box therapy. This therapy can then be utilized to improve motor function and manage pain in individuals recovering from various neurological and musculoskeletal conditions.