Action Observation Treatment on Motor Function in Upper Limb of Patients With Chronic Stroke

Study Overview
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Brief Summary
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To determine the effects of action observation treatment on motor functions in upper limb of patients with chronic stroke

Detailed Description
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Stroke is one of the major cause of death in Pakistan and also a prime source of disability in older adults.Mirror neuron system depends on motor regions, and its dominant aspect is that,it is activated for implementation of motor activity and also for its observation. This dual activation characteristic of mirror neuron helps in improving the observation and execution of different actions. aim of this study is to determine the effects of action observation treatment on motor function in upper limb of patients with chronic stroke. An RCT will be conducted on 14 chronic stroke patients from Omar Hospital and Riphah Rehabilitation Centre Lahore. Patients will be randomly allocated into control group (n=7) and Experimental group (n=7) by lottery method. Control group will be given only conventional treatment that included stretching, strengthening, pinching, gripping, reaching and grasping exercises, while Experimental group received conventional treatment and action observation treatment 3 days/ week for 4 weeks. Treatment outcomes will be assessed on Modified Barthel Index and Fugl-Meyer Assessment for upper extremity (FMA-UE)

Official Title
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Effects of Action Observation Treatment on Motor Function in Upper Limb of Patients With Chronic Stroke

Conditions
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Stroke

Intervention / Treatment
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* Combination Product: Action observation treatment
* Combination Product: conventional treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Chronic Stroke patients (with more than 6 months- 4 years) illness Patients that were able to communicate and comprehend oral instructions Patients with Mini Mental State Examination (MMSE) score more than 24 Exclusion Criteria: Patients having psychiatric histories. Visual and hearing impaired patients Patients with speech impairment Patients with arthritic deformities in upper limb (with or without using assistive device) Patients with diagnosed mental illness.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: each participant will be requested to draw either number one or two from a box.number one refers to group A and number two refers to group B. Group A patients will receive conventional treatment of 40 minutes in total. group B is experimental group , patients will watch videos of 5 common motor tasks that implicit the usage of items to be used for action observation treatment.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Action observation treatment<br>Action observation treatment | Combination Product: Action observation treatment<br>* Participants will watch 5 videos of motor tasks; each video is of 30 sec and watch for 4 times (i.e. for 2 minutes). Then patient will execute the motor act, soon after the observation with an affected limb for 2 minutes, with total rest time of 5 minutes for this treatment. Conventional treatment of muscle stretching, strengthening and ROM exercises will be given for 15 minutes including rest. Total treatment time is 40 minutes.<br>|
| Active Comparator: conventional treatment<br>conventional treatment | Combination Product: conventional treatment<br>* conventional treatment of 40 minutes in total will be performed including Stretching (for 8-10 sec with set of 5 repetitions/ session on each side for 3 minutes total with rest), strengthening (weighted bicep curls, side arm raise and open arm movement exercises with set of 5 repetitions/ session for 9 minutes total with rest), Range of motion exercises active and passive with set of 5 repetitions/ session for 3 minutes total with rest and gripping,reaching, grasping exercises (on each side for total 25 minutes including rest) with assistance of physiotherapist<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| modified barthal index | The Modified Barthel Index score was used for practical evaluation in activities of daily living. The MBI comprises of 10 items, 6 out of 10 items scored from 0-2 points, 2 items scored from 0-3 points and other 2 items scored from 0-3 points, giving a highest total score of 20 points. | 40 minutes | 
| Fugl-Meyer Assessment test | Fugl-Meyer Assessment test for Upper extermity.to assess level of motor impairment and its recovery after treatment. The FMA-UE comprises of 7 times. | 40 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, action observation treatment