Action observation for upper limb function after stroke: evidence-based review of randomized controlled trials

Abstract

[Purpose] The purpose of this study was to suggest evidenced information about action observation to improve upper limb function after stroke. [Methods] A systematic review of randomized controlled trials involving adults aged 18 years or over and including descriptions of action observation for improving upper limb function was undertaken. Electronic databases were searched, including MEDLINE, CINAHL, and PEDro (the Physiotherapy Evidence Database), for articles published between 2000 to 2014. Following completion of the searches, two reviewers independently assessed the trials and extracted data using a data extraction form. The same two reviewers independently documented the methodological quality of the trials by using the PEDro scale. [Results] Five randomized controlled trials were ultimately included in this review, and four of them (80%) reported statistically significant effects for motor recovery of upper limb using action observation intervention in between groups. [Conclusion] This review of the literature presents evidence attesting to the benefits conferred on stroke patints resulting from participation in an action observation intervention. The body of literature in this field is growing steadily. Further work needs to be done to evaluate the evidence for different conditions after stroke and different duration of intervention.

Enhanced Upper Extremity Functions with a Single Session of Action-Observation-Execution and Accelerated Skill Acquisition Program in Subacute Stroke

“…Elisabetta S et al [ 56 ] reviewed 20 randomized controlled trials (from or before 1982 to 2015) and found the beneficial effect of AO therapy on motor training including dexterity in subacute stroke. Kim K et al [ 10 ] conducted another review of randomized controlled trials (from 2000 to 2014) in which all included studies demonstrated significant improvement in motor function with AO therapy except a study by Cowles T et al [ 7 ], which did not show significant effect of AO therapy, which could be because they trained participants without videos. Incongruent movements between execution and observation also could not demonstrate better effect like that of congruent movements [ 25 ].…”

“…Even mild UE impairments after stroke significantly limit daily activities and negatively impact quality of life [ 5 ]. Evidence shows increasing attention to mirror neuron system-based interventions for functional training in stroke [ 6 – 10 ].…”

The Study of Action Observation Therapy in Neurological Diseases: A Few Technical Considerations

“…For both clinical conditions, the majority of the studies reported a clear beneit of AOT, with a maintained improvement in the motor condition and the functional status. In fact, the beneit of this therapy has been remarked on in a recent evidenced-based review of the literature concerning the efect of AOT in upper limb dysfunction after stroke [21].…”

Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial

“…7 Recently, some studies have reported on the potential benefits of mental practice and action observation training, for promoting motor skill acquisition, as an adjunct to physical training in patients with brain lesions such as stroke. 8–11…”

“…7 Recently, some studies have reported on the potential benefits of mental practice and action observation training, for promoting motor skill acquisition, as an adjunct to physical training in patients with brain lesions such as stroke. [8][9][10][11] A lack of walking competency in the community is strongly related to an impaired cognitive process, 12 which makes it difficult to establish attention and executive function in different community environments; this process can be facilitated by using action observation training. 10 Since the point of action observation is to observe another subject performing an action, it leads to recruitment in the same brain region as actual physical practice; moreover, it may reflect the same plastic cortical representation in the motor system as the actual performance of motor action, 10 possibly through the mirror neuron system.…”