The Feasibility of Action Observation and Repetitive Task Practice for Impairment, Function, and Spasticity Upper Limb Outcomes in Chronic Moderately Impaired Stroke Survivors

Abstract

<h3>Research Objectives</h3> To determine the feasibility of Action Observation (AO) + Repetitive Task Practice (RTP) compared to placebo + RTP interventions through detecting changes in Upper Limb (UL) impairment, function, and spasticity outcomes in the chronic stroke survivor. <h3>Design</h3> Randomized controlled single-blinded, parallel-group pilot study. <h3>Setting</h3> Outpatient Rehabilitation. <h3>Participants</h3> 10 to AO + RTP group, 5 to Placebo Video + RTP. <h3>Interventions</h3> AO: Watch a 6 minute video of another person completing a functional task RTP: Repeated physical performance of the functional task in the AO video with the hemiplegic UL Placebo: Watch a 6 minute video of a series of changing static images without animals, human beings, or sound. Practice Schedule: 6 minutes video, 24 minutes RTP, 6 minutes video, 24 minutes RTP Subjects completed an intervention for 1 hour, 3 times/ week, for 8 weeks (total 24 sessions), and a daily 30 minute Home Exercise Program. Data collection at pretest, post intervention, and 1 month post intervention. <h3>Main Outcome Measures</h3> Upper Extremity Fugl Meyer (UEFM) (Primary Outcome Measure), Arm Motor Ability Test (AMAT), and Modified Ashworth Scale (MAS). <h3>Results</h3> There was a significantly larger improvement in the AO + RTP group at Post 2, with the difference in the average change in UEFM was 8.2 (90% CI 4.0 - 12.4, p=0.006), and change in the AMAT Functional Ability of 8.3 (90% CI 2.2 - 14.5, p=0.034). There was not significant evidence of improvement for MAS elbow flexion in the AO plus RTP group at Post 2 (p=0.060) or MAS elbow extension (p=0.055). <h3>Conclusions</h3> The response to intervention would indicate that a larger Phase III RCT should be completed to determine efficacy for the intervention in the moderately impaired chronic stroke survivor population. <h3>Author(s) Disclosures</h3> None Disclosed.