Action Observation and Motor Imagery Therapy in Stroke

Official title

Effect of Action Observation and Motor Imagery Therapy on Balance, Functional Status and Quality of Life in Stroke, Randomized Controlled Trial

Overview

In recent years, motor imagery (MI) and action observation (AO) therapy strategies have been used in rehabilitation programs to increase motor learning in stroke. Visuomotor training strategies such as AO and MI therapy rely on the activity of the mirror neuron system to facilitate motor re-learning. Mirror neurons are activated during the performance of goal-directed actions, also when observing the same action and visualizing the action in the mind. This clinical trial aims to test whether the application of AO and MI treatment in stroke in addition to conventional rehabilitation programs has an additional effect on motor recovery, activities of daily living, and quality of life.

Detailed description

Stroke is one of the most common neurological disorders that causes chronic disability in adulthood. Stroke-related neurological dysfunction causes impairment in motor and sensory skills and limitation in the ability to perform daily living activities, resulting in decreased independence of patients. This process causes significant impairment in the quality of life of stroke patients.

In recent years, motor imagery (MI) and action observation (AO) therapy strategies have been used in rehabilitation programs to increase motor learning in stroke. Visuomotor training strategies such as AO and MI therapy rely on the activity of the mirror neuron system to facilitate motor re-learning. Mirror neurons are activated during the performance of goal-directed actions, also when observing the same action and visualizing the action in the mind.

This clinical trial aims to test whether the application of AO and MI treatment in stroke in addition to conventional rehabilitation programs has an additional effect on motor recovery, activities of daily living, and quality of life.

Interventions

• Other Action observation and motor imagery therapy for rehabilitation
  Action observation; Patients will watch some exercises accompanied by music from a previously prepared video for 10 minutes. Exercises include 8-10 repetitions of abduction-adduction, horizontal abduction-adduction, flexion-extension and supination-pronation movements for the upper extremity, and stepping, forward-backward stepping, side stepping and ankle dorsiflexion movements for the lower extremity. Motor imagery training; Patients will be asked to visualize the actions they watched in thei
• Other Sham action observation and motor imagery therapy for rehabilitation
  Sham action observation; Patients will watch a video consisting of static nature photographs for 10 minutes with the same music. Sham motor imaginary; Patients will think about the video they watched for 10 minutes. Then, they will watch another video in which the exercises are performed only once, and they will be asked to do the exercises. They will be given enough time to do 8-10 repetitions.

Primary outcome measures

• The difference in the scores of the Fugl-Meyer Assessment between pre- and post-rehabilitation assessments [Time frame: 6 weeks]
• The difference in the scores of the Brunnstrom stages between pre- and post-rehabilitation assessments [Time frame: 6 weeks]

Secondary outcome measures (2)

• The difference in the scores of the Barthel Index between pre- and post-rehabilitation assessments [Time frame: 6 weeks]
• The difference in the scores of the Stroke-Specific Quality of Life Scale between pre- and post-rehabilitation [Time frame: 6 weeks]

Eligibility criteria

Inclusion criteria

• Patients who had a stroke in the last year
• Functional Ambulation Classification score 2-5

Exclusion criteria

• Patients who have had repeated strokes
• Patients with neglect
• Patients with cognitive dysfunction (those who cannot follow simple verbal instructions)
• Patients with severe hearing problems
• Patients with severe vision problems
• Patients with additional musculoskeletal system pathology that will affect physical performance (such as amputation, severe joint mobility limitation, peripheral nerve damage)
• Patients with uncontrolled hypertension and diabetes mellitus
• Patients with a history of symptomatic lung disease (such as asthma, chronic obstructive pulmonary disease, emphysema)
• Patients with a history of symptomatic cardiac disease (such as coronary artery disease, arrhythmia, heart failure)
• Patients with peripheral artery disease

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Turkey (Türkiye) · 1 center

• Karaman Training and Research Hospital — Karaman

Identifiers

NCT: NCT06166862 · 09-2023/02

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗