Abstract
Abstract Aims: To investigate the effects of an exercise program with action observation versus conventional physical therapy on upper limb functionality in chronic stroke subjects. Methods: In this controlled clinical trial, thirty-five stroke patients were divided into two groups, experimental group, comprising eighteen patients that received an exercise program with action observation; and a control group, comprising seventeen patients that received conventional exercise program. Functional recovery was assessed with the Fugl-Meyer Scale, manual dexterity was assessed with the Box and Blocks test, and the functional use of the affected upper limb was assessed with the Reach scale. Evaluations occurred at baseline, after three and six months of intervention. Statistical analyses were performed with the Repeated Measures Analysis of Variance and the Friedman test, under a 5% significance. Results: Both interventions provided benefits to chronic stroke patients. Exercise program with action observation presented better results on motor recovery (p < 0.001) and functional use of the affected limb (p < 0.001) when compared with conventional therapy. Both treatments improved the manual dexterity of the participants (p = 0.002), but in a similar way (p = 0.461). Conclusion: A six-month exercise program with action observation provided benefits on functional recovery and functional use of an affected upper limb in chronic stroke patients. Exercises with action observation demonstrated the potential for improving affected upper limb in chronic stroke patients.
Highlights
Recovery of the affected upper limb is one of the great challenges in the rehabilitation of stroke patients
In the present study, we investigated the benefits of Action observation training (AO) in comparison to conventional physical therapy on upper limb functional recovery, manual dexterity and Exercises with action observation contributes to upper limb recovery after stroke everyday use of the affected upper limb in individuals with stroke
We hypothesized that AO would present better outcomes to patients with stroke than a conventional exercise program. This is a controlled clinical trial comparing the effects of AO versus conventional exercise program in chronic stroke patients
Summary
Recovery of the affected upper limb is one of the great challenges in the rehabilitation of stroke patients. 60% of severely affected individuals do not present manual dexterity six months after the stroke[1]. The functional deficits of the upper limb affect the ability for self-care, contribute to low perceived quality of life and higher healthcare services costs[2,3]. Exercise programs should start early, be intensive and developed with the active participation of patients to promote motor learning and minimize functional deficits[4]. AO stimulates the mirror neuron system, a special type of neurons activated by the execution and observation of action[6]. By its connections with neurocognitive processing, exercises programs that stimulate the mirror neuron system may promote important benefits to stroke patients[6,7]
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