Effect of Action Observation Therapy in the Rehabilitation of Neurologic and Musculoskeletal Conditions: A Systematic Review

Abstract

Objective To investigate the effect of action observation therapy (AOT) in the rehabilitation of neurologic and musculoskeletal conditions. Data Sources Searches were completed until July 2020 from the electronic databases Allied and Complementary Medicine Database (via OVID SP), Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EMBASE, MEDLINE, and the Physiotherapy Evidence Database. Study Selection Randomized controlled trials comparing AOT with standard care were assessed. Musculoskeletal (amputee, orthopedic) and neurologic (dementia, cerebral palsy, multiple sclerosis, Parkinson disease, stroke) conditions were included. There were no age limitations. Articles had to be available in English. Data Extraction Two reviewers independently screened titles, abstracts and full extracts of studies for eligibility and assessed the risk of bias of each study using the Cochrane Risk of Bias Tool. Data extraction included participant characteristics and intervention duration, frequency, and type. Results The effect of AOT in different outcome measures (OMs) was referenced in terms of body structures and functions, activities and participation, and environmental factors as outlined by the International Classification of Functioning, Disability, and Health (ICF). Of the 3448 articles identified, 36 articles with 1405 patients met the inclusion criteria. Seven of the 11 meta-analyses revealed a significant effect of intervention, with results presented using the mean difference and 95% CI. A best evidence synthesis was used across all OMs. Strong evidence supports the use of AOT in the rehabilitation of individuals with stroke and Parkinson disease; moderate evidence supports AOT in the rehabilitation of populations with orthopedic and multiple sclerosis diagnoses. However, moderate evidence is provided for and against the effect of AOT in persons with Parkinson disease and cerebral palsy. Conclusions This review suggests that AOT is advantageous in the rehabilitation of certain conditions in improving ICF domains. No conclusions can be drawn regarding treatment parameters because of the heterogeneity of the intervention. AOT has been considerably less explored in musculoskeletal conditions.

Effectiveness of motor imagery for improving functional performance after total knee arthroplasty: a systematic review with meta-analysis

“…Due to few related articles, the clinical significance of OKS and WOMAC change needs to be confirmed by more studies. Only a similar study supported action observation in improving WOMAC in patients with knee and hip arthroplasty [ 37 ]. It gave us a hint that researchers might prefer objective TUG and gait speed to subjective OKS and WOMAC.…”

“…This was consistent with articles using other movement representation techniques. Two studies observed greater ROM in the action observation group for TKA patients in acute phase [ 37 ]. Another meta-analysis showed a moderate positive effect on the knee extension and flexion of the affected leg for patients with TKA or total hip arthroplasty [ 35 ].…”

Effectiveness of mental simulation practices after total knee arthroplasty in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

“…Discussion on the representation and simulation of motor acts dates back to as early as 1825 by the German philosopher and psychologist, Johann Friedrich Herbart, who proposed that the imagery of perceptual effects can elicit related movements [ 49 ]. It has since then been explored in various aspects of sports [ 50 ] and medicine [ 14 – 18 , 51 ]. Mental simulation practice has been used to rehabilitate motor deficits in various neurological [ 52 ] and musculoskeletal disorders [ 17 , 18 , 51 ].…”

“…It has since then been explored in various aspects of sports [ 50 ] and medicine [ 14 – 18 , 51 ]. Mental simulation practice has been used to rehabilitate motor deficits in various neurological [ 52 ] and musculoskeletal disorders [ 17 , 18 , 51 ]. A systematic review and meta-analysis reported multiple positive effects on measures of physical function recovery compared with SPT in patients after TKA or THA [ 29 ].…”

The Added Value of Point-Light Display Observation in Total Knee Arthroplasty Rehabilitation Program: A Prospective Randomized Controlled Pilot Study

“…While AOT efficacy has been clearly proven for rehabilitation of central disorders [12], this approach has been significantly less studied in peripheral disorders [13][14][15]. In a randomized case-control study, Bellelli et al [13] used a 3-week combined program including conventional post-orthopedic rehabilitation (1 h a day, 6 days a week) and AOT (24 min a day, 6 days a week) in 60 patients with post-orthopedic surgery (hip arthroplasty, knee arthroplasty, hip fracture repair).…”