Effectiveness of action observation therapy on upper extremity function in children with cerebral palsy: systematic review and meta-analysis

Abstract

Background Action observation therapy is a novel rehabilitation tool. It is a top-down approach based on mirror neuron system recruitment. Objectives To evaluate action observation therapy’s effectiveness in improving upper limb function in children with cerebral palsy and perform a meta-analysis to synthesize data across statistically similar studies. Methods Data Sources: Included The Web of Science, Science Direct, OVID, PubMed, Physiotherapy Evidence Database PEDro, and the Cochrane Library. Study selection: The authors included randomized controlled trials that studied the effect of action observation therapy alone or associated with other treatment methods on upper limb function in children with cerebral palsy. Five studies met the inclusion criteria. Study appraisal: Two authors extracted data independently and assessed the risk of bias using The Cochrane Collaboration tool for assessing the risk of bias in randomized trials. Results Of the five studies chosen for review, we included three in the meta-analysis. There was no significant difference between action observation therapy with repeated action versus repeated action alone in the hand assessment (AHA) scale, the Melbourne Assessment of Unilateral Upper Limb (MUUL), and ABILHAND- Kids (P-values 0.53, 0.26, 0.89, respectively). Conclusions Action observation therapy has no advantage over traditional functional motor training in improving upper limb function in rehabilitating children with cerebral palsy.