Comparative Efficacy Study of Action Observation Therapy and Mirror Therapy After Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The specific aims of this study will be to:

        1. investigate the treatment efficacy of Action observation therapy (AOT), mirror therapy
           (MT) versus a control intervention on motor and functional outcomes of stroke patients.

        2. compare the mechanisms and changes in cortical neural activity after AOT, MT, and
           control intervention by using magnetoencephalography (MEG).

        3. determine the correlations between neural activation changes and clinical outcomes after
           AOT and MT.

        4. identify who are the potential good responders to AOT and MT.
    

Detailed description: 
      In this 3-year study project, the investigators will design a comparative, randomized
      controlled trial to (1) investigate the treatment efficacy of AOT, MT versus a control
      intervention on motor and functional outcomes of stroke patients, (2) compare the mechanisms
      and changes in cortical neural activity after AOT, MT, and control intervention by using
      magnetoencephalography (MEG), (3) determine the correlations between neural activation
      changes and clinical outcomes after AOT and MT, and (4) identify who are the potential good
      responders to AOT and MT. An estimated total of 90 patients with subacute stroke will be
      recruited in this study. All participants will be randomly assigned to receive AOT, MT, or
      control intervention for a 3-week training period (a total of 15 sessions). Outcome measures
      will be conducted at baseline, immediately after treatment, and 3 months follow-up. For the
      MEG study, the investigators anticipate to recruit 12 to 15 patients in each group. The
      patients can still participate in this study to receive treatments and clinical evaluations
      even if they do not meet the MEG eligibility criteria or are not willing to participate in
      the MEG study.
    

Intervention name(s): Action observation therapy; Mirror therapy; Customary bilateral UE training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The patients were asked to observe everyday life actions of which they had motor experience or the actions belong to the motor repertoire of observers', they had better performance. The common categories of motor actions and tasks for stroke patients are selected in this study: (a) active range of motion (AROM) exercises, (b) reaching movement or object manipulation, and (c) upper-extremity (UE) functional tasks practice.; The MT group will receive 60 minutes of upper-limb training in a mirror box. MT treatment activities will include AROM exercises (10 to 15 minutes), reaching movement or object manipulation (15 to 20 minutes), and functional tasks practice (30 minutes) in a mirror box.; The participants in this group will receive dose-matched customary bilateral UE training programs for 1 hour per session. The treatment protocol of control group will also include: (a) AROM exercises (10 to 15 minutes), (b) reaching movement or object manipulation (15 to 20 minutes), and (3) functional tasks practice (30 minutes).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: stroke; translational rehabilitation; mirror neuron system; action observation; mirror therapy; MEG