Action Observation, Imagery and Execution for Stroke Rehabilitation
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The specific study aims will be:

        1. To investigate the short- and long-term treatment effects of action observation,
           imagery, and execution therapy (AOIE) compared with an action observation therapy (AO)
           group and a control treatment group as controls on different aspects of outcomes in
           patients with stroke.

        2. To examine the neural mechanisms and changes in cortical neural activity after the
           interventions in stroke patients.

        3. To examine the correlations between AOIE-induced brain activation changes and the
           clinical efficacy of AOIE.

        4. To identify who are the possible good responders to the therapy based on baseline motor
           function and motor imagery ability of the participants.
    

Detailed description: 
      The investigators propose a 3-year randomized controlled trial to (1) investigate the short-
      and long-term treatment efficacy of AOIE, action observation alone, versus control treatment
      on clinical outcomes of patients with subacute stroke, (2) examine the neural mechanisms and
      activation changes after the 3 interventions by using an advanced brain imaging technique,
      magnetoencephalography (MEG), (3) determine the correlations between neural activation
      changes and clinical outcomes, and (4) identify who are the good responders to the AOIE
      therapy. An estimated total of 96 patients with subacute stroke will be recruited in this
      study. All participants will be randomly assigned to receive 1 of the 3 interventions for 3
      weeks (a total of 15 sessions). Clinical outcome measures will be conducted at baseline,
      immediately after treatment (3 weeks), and at 3 months follow-up. The MEG assessment will be
      conducted at baseline and immediately after treatment (3 weeks). For the MEG study, The
      investigators anticipate to enroll 12 to 15 patients in each group to complete neuroimaging
      evaluation because of the specific eligibility criteria and high costs of MEG. The patients
      can still participate in the study, receiving rehabilitation therapy and clinical
      evaluations, even if the participants will not be included in the MEG study.
    

Intervention name(s): Action observation, imagery & execution; Action observation; Control treatment
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The participants will be asked to observe movements through a video clip, practice motor imagery, and executing the movements that the participants observed.; The participants will be asked to observe videos and then practice what the participants observed.; The participants will receive UE training without watching videos or imagining movements/tasks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: stroke; neurorehabilitation; mirror neuron system; action observation; motor imagery; MEG