The "mirror box" illusion: effect of visual information on bimanual coordination in children with spastic hemiparetic cerebral palsy

The study examined symmetrical bimanual coordination of children with spastic hemiparetic cerebral palsy (SHCP) and a typically developing (TD) control group under conditions of visual feedback created by placing a glass screen, opaque screen or a mirror ("mirror box") between the arms. The "mirror box" creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two arms. Children with SHCP exhibited a similar mean coordination pattern as the TD control group, but had greater movement variability between the arms. Furthermore, movement variability in children with SHCP was significantly greater in the screen condition compared with the glass and mirror condition, which were similar to each other. The effects of the availability of visual feedback in individuals with hemiparesis are discussed with reference to central and peripheral mechanisms.