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

Research Objectives 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. Design Randomized controlled single-blinded, parallel-group pilot study. Setting Outpatient Rehabilitation. Participants 10 to AO + RTP group, 5 to Placebo Video + RTP. Interventions 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. Main Outcome Measures Upper Extremity Fugl Meyer (UEFM) (Primary Outcome Measure), Arm Motor Ability Test (AMAT), and Modified Ashworth Scale (MAS). Results 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). Conclusions 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. Author(s) Disclosures None Disclosed.