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J Rehabil Med. 2012 Nov;44(11):939-43. doi: 10.2340/16501977-1048.

Motion of the drawing hand induces a progressive increase in muscle activity of the non-dominant hand in Ramachandran's mirror-box therapy.

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  • 1Faculty of Rehabilitation and Care, Seijoh University, Aichi, Japan.



To observe the real-time muscle activity of bilateral hands while subjects draw circles under 2 conditions: with and without using Ramachandran's mirror-box.


A total of 24 healthy volunteers.


Subjects drew 4 circles sequentially using their dominant hand with the other hand at rest, both with and without looking at a mirror image. Circles were marked by 8 dots on the paper, which subjects connected up to draw the shape. The activity of the bilateral first dorsal interosseus muscles was recorded using surface electromyography.


Muscle activity of the dominant hand remained constant during each task. In contrast, muscle activity of the non-dominant hand increased under the condition of watching the image in the mirror, but was low under the non-watching condition. Furthermore, muscle activity of the non-dominant hand increased over the duration of the task. However, wide variation between subjects was observed under the mirror-image condition.


Increased muscle action potential of the non-dominant hand may be induced by the circle drawing task of the dominant hand during Ramachandran's mirror-box therapy, which supports previous observations of increased brain activity caused by watching a mirror image.

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