The effects of action observation training and mirror therapy on gait and balance in stroke patients.
Ho Jeong Lee, Young Mi Kim, Dong Kyu Lee
PMID 28356646WHAT IT FOUND
No group clearly outperformed the others.
Watching movement videos then practicing them, with twice-weekly physical therapy, showed improved standing balance scores and shorter walking task times. Mirror therapy with physical therapy showed shorter walking task times. Watching videos alone did not show these changes.
Key findings
01In the group that watched movement videos and then practiced the same movements, with general physical therapy, Overall Balance Index and Anteroposterior Balance Index scores decreased; the mirror therapy and observation-only groups did not show such decreases.
02With general physical therapy, the action observation plus activity and mirror therapy plus activity groups showed significant decreases in Modified Functional Ambulation Profile scores, while the observation-only group did not, and no group was significantly better than another.
03Mediolateral Balance Index and fall risk did not change significantly in any group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only 35 participants, with 11 to 12 in each group. No dropout or completion numbers were reported. All groups received general physical therapy twice per week, so the contribution of action observation, mirror therapy, or physical practice cannot be separated. Participants had to be able to walk 10 m independently and score 23 or higher on the Mini Mental State Examination, so results may not apply to more severely impaired stroke patients. The paper did not confirm whether the improvements persisted after the six-week program. No group showed significant between-group differences, so the study does not identify a superior intervention.
The easy way to misread this
Do not conclude that action observation plus practice is better than mirror therapy or observation alone. The study found no significant difference between the groups, and every group also received general physical therapy, so the added component cannot be separated.