Effects of Action Observation Exercises with Complex Tasks on Upper Limb Function in Acute Stroke

Abstract

Background: Stroke is a leading cause of disability worldwide, necessitating effective rehabilitation strategies. Action observation therapy, a novel approach in stroke rehabilitation, focuses on improving motor function and functional recovery by leveraging the activation of mirror neurons through the observation and subsequent replication of actions. Objective: The study aimed to compare the effects of action observation therapy with conventional therapy on motor function, manual dexterity, and functional recovery in patients with acute stroke. Methods: This randomized control trial enrolled 58 acute stroke patients, divided equally into an experimental group (action observation therapy) and a control group (conventional therapy). Participants, aged 40-75 years, were selected using non-probability purposive sampling and randomized via a coin toss method. The study was conducted at Rafsan Neuro Rehab Center, Peshawar, over six months. Inclusion criteria included acute stroke phase, MMSE >24, and Fugl-Meyer Assessment score ≥20. Exclusion criteria were posterior circulation infarction, multiple strokes, and cognitive impairments. Outcome measures included the Fugl-Meyer Assessment scale, Box and Block test, and the REACH scale. Data were analyzed using SPSS v25, employing parametric and non-parametric tests as appropriate. Results: The experimental group showed a significant improvement in motor functions and functional recovery, with post-treatment Fugl-Meyer scores increasing from 29.69 ± 5.04 to 57.31 ± 4.01 (p = 0.001). The control group also exhibited improvement, with scores rising from 27.00 ± 4.71 to 54.24 ± 5.14 (p = 0.001). However, improvements in manual dexterity, as measured by the Box and Block test, were not statistically significant. Conclusion: Action observation therapy significantly enhances motor functions and functional recovery in acute stroke patients compared to conventional therapy, although its impact on manual dexterity requires further investigation. These findings suggest that incorporating action observation into stroke rehabilitation protocols could be beneficial.