Clinical feasibility of action observation training for walking function of patients with post-stroke hemiparesis: a randomized controlled trial

Objective: To identify the effects of action observation training (AOT) on the walking ability of subjects with post-stroke hemiparesis. Design: Randomized, single-blind, controlled pilot study. Setting: Inpatient rehabilitation hospital. Subjects: Twenty-one subjects with post-stroke hemiparesis were randomly allocated to either the experimental group (EG) or the control group (CG), with 11 and 10 patients, respectively. Interventions: The subjects in the EG and CG watched video clips demonstrating four functional walking tasks and showing different landscape images, respectively. All subjects subsequently performed the walking tasks (a total of 30 min, once a day, 3 times weekly for a 4-week period). Main measures: 10-m walk test, figure-of-8 walk test (time and steps), dynamic gait index (DGI), and gait symmetry score (swing and stance phases, and stride length) before and after the intervention. Results: The changes between the pre- and post-test values of the 10-m walk test (median [interquartile range], -5.10 [-15.80--1.60] versus 0.00 [-6.60-4.06]), figure-of-8 walk test (time: -3.50 [-12.60--2.00] versus -1.25 [-4.98-0.25]; steps:-5.00 [-8.00--2.00] versus 0.00 [-3.25-0.25]), and DGI (4.00 [3.00-6.00] versus 1.00 [-4.00-3.00]) showed significant differences between the EG and CG (p < 0.05). In the EG, the 10-m walk test, time and steps of figure-of-8 walk test, DGI, and gait symmetry score in the stance phase showed significant differences between pre- and post-test (p < 0.05). Conclusions: The findings suggest that AOT can be beneficial in enhancing walking ability of patients with post-stroke hemiparesis, and may be clinically feasible as a practical adjunct to routine rehabilitation therapy. A power calculation on our data showed that 20 subjects in each group were required for further definitive studies.