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. 2022 Aug 5;8(8):CD011887.
doi: 10.1002/14651858.CD011887.pub3.

Action observation for upper limb rehabilitation after stroke

Lorenna Rdm Borges  1 , Aline Bgs Fernandes  2 , Jacilda Oliveira Dos Passos  1 , Isabelle Ananda Oliveira Rego  1 , Tania F Campos  1
Affiliations

Action observation for upper limb rehabilitation after stroke

Lorenna Rdm Borges et al. Cochrane Database Syst Rev. .

Abstract

Background: Action observation (AO) is a physical rehabilitation approach that facilitates the occurrence of neural plasticity through the activation of the mirror-neural system, promoting motor recovery in people with stroke.

Objectives: To assess whether AO enhances upper limb motor function in people with stroke.

Search methods: We searched the Cochrane Stroke Group Trials Register (last searched 18 May 2021), the Cochrane Central Register of Controlled Trials (18 May 2021), MEDLINE (1946 to 18 May 2021), Embase (1974 to 18 May 2021), and five additional databases. We also searched trial registries and reference lists.

Selection criteria: Randomized controlled trials (RCTs) of AO alone or associated with physical practice in adults after stroke. The primary outcome was upper limb (arm and hand) motor function. Secondary outcomes included dependence on activities of daily living (ADL), motor performance, cortical activation, quality of life, and adverse effects.

Data collection and analysis: Two review authors independently selected trials according to the predefined inclusion criteria, extracted data, assessed risk of bias using RoB 1, and applied the GRADE approach to assess the certainty of the evidence. The reviews authors contacted trial authors for clarification and missing information.

Main results: We included 16 trials involving 574 individuals. Most trials provided AO followed by the practice of motor actions. Training varied between 1 day and 8 weeks of therapy, 10 to 90 minutes per session. The time of AO ranged from 1 minute to 10 minutes for each motor action, task or movement observed. The total number of motor actions ranged from 1 to 3. Control comparisons included sham observation, physical therapy, and functional activity practice.

Primary outcomes: AO improved arm function (standardized mean difference (SMD) 0.39, 95% confidence interval (CI) 0.17 to 0.61; 11 trials, 373 participants; low-certainty evidence); and improved hand function (mean difference (MD) 2.76, 95% CI 1.04 to 4.49; 5 trials, 178 participants; low-certainty evidence).

Secondary outcomes: AO did not improve ADL performance (SMD 0.37, 95% CI -0.34 to 1.08; 7 trials, 302 participants; very low-certainty evidence), or quality of life (MD 5.52, 95% CI -30.74 to 41.78; 2 trials, 30 participants; very low-certainty evidence). We were unable to pool the other secondary outcomes (motor performance and cortical activation). Only two trials reported adverse events without significant adverse effects.

Authors' conclusions: The effects of AO are small for arm function compared to any control group; for hand function the effects are large, but not clinically significant. For both, the certainty of evidence is low. There is no evidence of benefit or detriment from AO on ADL and quality of life of people with stroke; however, the certainty of evidence is very low. As such, our confidence in the effect estimate is limited because it will likely change with future research.

Trial registration: ClinicalTrials.gov NCT02235350 NCT04015271 NCT04047134 NCT04574687 NCT04943601.

PubMed Disclaimer

Conflict of interest statement

Lorenna RDM Borges: none known Aline Fernandes: none known Jacilda Passos: none known Isabelle Rego: none known Tania F Campos: none known

Figures

1
1
Study flow diagram
2
2
Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included trials.
4
4
Funnel plot of comparison: 1 Action observation therapy versus control: effect on arm function, outcome: Analysis 1.1. Arm function.
1.1
1.1. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 1: Arm function
1.2
1.2. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 2: Subgroup analysis: age
1.3
1.3. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 3: Subgroup analysis: type of stroke
1.4
1.4. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 4: Subgroup analysis: time poststroke
1.5
1.5. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 5: Subgroup analysis: treatment dose
1.6
1.6. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 6: Subgroup analysis: type of control group
1.7
1.7. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 7: Subgroup analysis: duration of observation
1.8
1.8. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 8: Subgroup analysis: upper limb impairment
1.9
1.9. Analysis
Comparison 1: Action observation versus control: effect on arm function, Outcome 9: Arm function follow‐up
2.1
2.1. Analysis
Comparison 2: Action observation versus control: effect on hand function, Outcome 1: Hand function
2.2
2.2. Analysis
Comparison 2: Action observation versus control: effect on hand function, Outcome 2: Subgroup analysis: age
2.3
2.3. Analysis
Comparison 2: Action observation versus control: effect on hand function, Outcome 3: Subgroup analysis: time poststroke
2.4
2.4. Analysis
Comparison 2: Action observation versus control: effect on hand function, Outcome 4: Subgroup analysis: duration of observation
2.5
2.5. Analysis
Comparison 2: Action observation versus control: effect on hand function, Outcome 5: Hand function follow‐up
3.1
3.1. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 1: Dependence on ADL
3.2
3.2. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 2: Subgroup analysis: age
3.3
3.3. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 3: Subgroup analysis: type of stroke
3.4
3.4. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 4: Subgroup analysis: time poststroke
3.5
3.5. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 5: Subgroup analysis: treatment dose
3.6
3.6. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 6: Subgroup analysis: type of control group
3.7
3.7. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 7: Subgroup analysis: duration of observation
3.8
3.8. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 8: Subgroup analysis: upper limb impairment
3.9
3.9. Analysis
Comparison 3: Action observation versus control: effect on ADL, Outcome 9: Dependence on ADL follow‐up
4.1
4.1. Analysis
Comparison 4: Action observation versus control: effect on quality of life, Outcome 1: Quality of life
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References

References to studies included in this review

Celnik 2008 {published and unpublished data}
    1. Celnik P, Webster B, Glasser DM, Cohen LG. Effects of action observation on physical training after stroke. Stroke 2008;39(6):1814-20. [DOI: 10.1161/STROKEAHA.107.508184] - DOI - PMC - PubMed
Cowles 2013 {published and unpublished data}
    1. Cowles T, Clark A, Mares K, Peryer G, Stuck R, Pomeroy V. Observation-to-imitate plus practice could add little to physical therapy benefits within 31 days of stroke: translational randomized controlled trial. Neurorehabilitation and Neural Repair 2013;27(2):173-82. [DOI: 10.1177/1545968312452470] - DOI - PubMed
Dettmers 2014 {published and unpublished data}
    1. Dettmers C, Nedelko V, Hassa T, Starrost K, Schoenfeld MA. Video therapy: promoting hand function after stroke by action observation training – a pilot randomized controlled rial. International Journal of Physical Medicine and Rehabilitation 2014;2(189):2. [2329-9096]
Ertelt 2007 {published and unpublished data}
    1. Ertelt D, Hemmelmann C, Dettmers C, Ziegler A, Binkofski F. Observation and execution of upper-limb movements as a tool for rehabilitation of motor deficits in paretic stroke patients: protocol of a randomized clinical trial. BMC Neurology 2012;12(1):42. [DOI: 10.1186/1471-2377-12-42] - DOI - PMC - PubMed
Franceschini 2012 {published and unpublished data}
    1. Franceschini M, Ceravolo MG, Agosti M, Cavallini P, Bonassi S, Dall’Armi V, et al. Clinical relevance of action observation in upper-limb stroke rehabilitation a possible role in recovery of functional dexterity. A randomized clinical trial. Neurorehabilitation and Neural Repair 2012;26(5):456-62. [DOI: 10.1177/1545968311427406] - DOI - PubMed
    1. Sale P, Ceravolo MG, Franceschini M. Action observation therapy in the subacute phase promotes dexterity recovery in right-hemisphere stroke patients. BioMed Research International 2014;2014:1-7. [DOI: 10.1155/2014/457538] - DOI - PMC - PubMed
Fu 2017 {published data only}
    1. Fu J, Zeng M, Shen F, Cui Y, Zhu M, Gu X, et al. Effects of action observation therapy on upper extremity function, daily activities and motion evoked potential in cerebral infarction patients. Medicine 2017;96(42):1-6. - PMC - PubMed
Harmsen 2015 {published and unpublished data}
    1. Harmsen WJ, Bussmann JB, Selles RW, Hurkmans HL, Ribbers GM. A mirror therapy-based action observation protocol to improve motor learning after stroke. Neurorehabilitation and Neural Repair 2015;29(6):509-16. [DOI: 10.1177/1545968314558598] - DOI - PubMed
Hsieh 2020 {published data only}
    1. Hsieh Y-W, Lin Y-H, Zhu J-D, Wu C-Y, Lin Y-P, Chen C-C. Treatment effects of upper limb action observation therapy and mirror therapy on rehabilitation outcomes after subacute stroke: a pilot study. Behavioural Neurology 2020;2020:1-9. [DOI: 10.1155/2020/6250524] - DOI - PMC - PubMed
Jin‐Woo 2011 {published data only}
    1. Jin-Woo J, Soon BY, Lee MK. The effect of action observation training on upper extremity function in chronic stroke patients. Journal of Korean Society of Occupational Therapy 2011;19:15–24.
Kim 2015 {published data only}
    1. Kim E, Kim K. Effect of purposeful action observation on upper extremity function in stroke patients. Journal of Physical Therapy Science 2015;27(9):2867-9. [DOI: 10.1589/jpts.27.2867] - DOI - PMC - PubMed
    1. Kim E, Kim K. Effects of purposeful action observation on kinematic patterns of upper extremity in individuals with hemiplegia. Journal of Physical Therapy Science 2015;27(6):1809-11. [DOI: 10.1589/jpts.27.1809] - DOI - PMC - PubMed
Kim 2016a {published data only}
    1. Kim C, Bang D. Action observation training enhances upper extremity function in subacute stroke survivor with moderate impairment: a double-blind, randomized controlled pilot trial. Journal of the Korean Society of Physical Medicine 2016;11(1):133-40. [10.13066/kspm.2016.11.1.133]
Kuk 2016 {published data only}
    1. Kuk E, Kim J, Oh D, Hwang H. Effects of action observation therapy on hand dexterity and EEG-based cortical activation patterns in patients with post-stroke hemiparesis. Topics in Stroke Rehabilitation 2016;23(5):318-25. [DOI: 10.1080/10749357.2016.1157972] - DOI - PubMed
Lee 2013 {published and unpublished data}
    1. Lee D, Roh H, Park J, Lee S, Han S. Drinking behavior training for stroke patients using action observation and practice of upper limb function. Journal of Physical Therapy Science 2013;25(5):611-4. [DOI: 10.1589/jpts.25.611] - DOI - PMC - PubMed
Mancuso 2021 {published and unpublished data}
    1. Mancuso M, Di Tondo S, Costantini E, Damora A, Sale P, Abbruzzese L. Action observation therapy for upper limb recovery in patients with stroke: a randomized controlled pilot study. Brain Sciences 2021;11(3):1-12. [DOI: 10.3390/brainsci11030290] - DOI - PMC - PubMed
Younghwa 2013 {published data only}
    1. Younghwa G, Bora K. An impact of action-observation training and task-oriented training on activities of daily living of stroke patients. Journal of Korean Integrative Medicine 2013;1(3):19-28.
Zhu 2015 {published and unpublished data}
    1. Zhu MH, Wang J, Gu XD, Shi MF, Zeng M, Wang CY, et al. Effect of action observation therapy on daily activities and motor recovery in stroke patients. International Journal of Nursing Sciences 2015;2(3):279-82. [DOI: 10.1016/j.ijnss.2015.08.006] - DOI

References to studies excluded from this review

Brunner 2014 {published data only}
    1. Brunner IC, Skouen JS, Ersland L. Plasticity and response to action observation: a longitudinal FMRI study of potential mirror neurons in patients with subacute stroke. Neurorehabilitation and Neural Repair 2014;28(9):874-84. [DOI: 10.1177/1545968314527350] - DOI - PubMed
Cha 2015 {published data only}
    1. Cha Y, Yoo E, Jung M, Park S, Park J, Lee J. Effects of mental practice with action observation training on occupational performance after stroke. Journal of Stroke and Cerebrovascular Diseases 2015;24(6):1405-13. - PubMed
Chang 2017 {published data only}
    1. Chang M, Kim H, Kim K, Oh J, Jang C, Yoon T. Effects of observation of hand movements reflected in a mirror on cortical activation in patients with stroke. Journal of Physical Therapy Science 2017;29(1):38-42. - PMC - PubMed
Emmerson 2017 {published data only}
    1. Emmerson K, Harding K, Taylor N. Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial. Clinical Rehabilitation 2017;31(8):1068-77. - PubMed
Ertelt 2012 {published data only}
    1. Ertelt D, Hemmelmann C, Dettmers C, Ziegler A, Binkofsk F. Observation and execution of upper-limb movements as a tool for rehabilitation of motor deficits in paretic stroke patients: protocol of a randomized clinical trial. BMC Neurology 2012;12(1):42. [DOI: 10.1186/1471-2377-12-42] - DOI - PMC - PubMed
Franceschini 2010a {published data only}
    1. Franceschini M, Agosti M, Cantagallo A, Sale P, Mancuso M, Buccino G. Mirror neurons: action observation treatment as a tool in stroke rehabilitation. European Journal of Physical and Rehabilitation Medicine 2010;46(4):517-23. [MEDLINE: ] - PubMed
Frenkel‐Toledo 2014 {published data only}
    1. Frenkel-Toledo S, Bentin S, Perry A, Liebermann D, Soroker N. Mirror-neuron system recruitment by action observation: effects of focal brain damage on mu suppression. NeuroImage 2014;87:127-37. - PubMed
Kim 2010 {published data only}
    1. Kim J, Yang B, Lee M. The effect of action observational physical training on manual dexterity in stroke patients. Physical Therapy Korea 2010;17(2):17-24.
Kim 2013a {published data only}
    1. Kim J, Chung E, Lee B. A study of analysis of the brain wave with respected to action observation and motor imagery: a pilot randomized controlled trial. Physical Therapy Science 2013;25(7):779-82. [DOI: 10.1589/jpts.25.779] - DOI - PMC - PubMed
Kim 2013b {published data only}
    1. Kim JH, Lee BH. Action observation training for functional activities after stroke: a pilot randomized controlled trial. NeuroRehabilitation 2013;33(4):565-74. [DOI: 10.3233/NRE-130991] - DOI - PubMed
Kim 2014 {published data only}
    1. Kim SS, Kim TH, Lee BH. Effects of action observational training on cerebral hemodynamic changes of stroke survivors: a fTCD study. Journal of Physical Therapy Science 2014;26(3):331-4. [10.1589/jpts.26.331] - PMC - PubMed
Kim 2016b {published data only}
    1. Kim T, Kim S, Lee B. Effects of action observational training plus brain-computer interface-based functional electrical stimulation on paretic arm motor recovery in patient with stroke: a randomized controlled trial. Occupational Therapy International 2016;23(1):39-47. [DOI: 10.1002/oti.1403] - DOI - PubMed
Ko 2014 {published data only}
    1. Ko H-E, Park J-J, Lee K-J, Lee E-H, Oh M-H. The effect of action-observational physical training based on mirror neuron system on upper extremity function and activities of daily living in stroke patient. Journal of the Korea Institute of Electronic Communication Sciences 2013;9(1):123-30.
Lee 2016 {published data only}
    1. Lee H, Kim H, Kwon H, Cho Y, Lee S. Effects of the distant action observation training program on function restorations of chronic stroke patients. Journal of Korean Society of Occupational Therapy 2016;24(1):1-13. [DOI: 10.14519/jksot.2016.24.1.01] - DOI
Liepert 2014 {published data only}
    1. Liepert J, Greiner J, Dettmers C. Motor excitability changes during action observation in stroke patients. Journal of Rehabilitation Medicine 2014;46(5):400-5. [DOI: 10.2340/16501977-1276] - DOI - PubMed
Lima 2020 {published data only}
    1. Lima AC, Christofoletti G. Exercises with action observation contribute to upper limb recovery in chronic stroke patients: a controlled clinical trial. Motriz 2020;26(1):e10200148.
Lubart 2017 {published data only}
    1. Lubart A, Leibovitz A, Peleg L, Yarovoy A, Gal G, Mizrahi E, et al. Action observation of motor skills followed by immediate sleep enhances the motor rehabilitation of older adults with stroke. Journal of Geriatric Physical Therapy 2017 Jun 21 [Epub ahead of print]. [2152-0895] - PubMed
Marangon 2014 {published data only}
    1. Marangon M, Priftis K, Fedeli M, Masiero S, Tonin P, Piccione F. Lateralization of motor cortex excitability in stroke patients during action observation: a TMS study. BioMed Research International 2014;2014. - PMC - PubMed
Sale 2012 {published data only}
    1. Sale P, Franceschini M. Action observation and mirror neuron network: a tool for motor stroke rehabilitation. European Journal of Physical and Rehabilitation Medicine 2012;48(2):313-8. [PMID: ] - PubMed
Shih 2017 {published data only}
    1. Shih TY, Wu CY, Lin KC, Cheng CH, Hsieh YW, Chen CL, et al. Effects of action observation therapy and mirror therapy after stroke on rehabilitation outcomes and neural mechanisms by MEG: study protocol for a randomized controlled trial. Trials 2017;18((1 CC-Stroke)):459. [DOI: 10.1186/s13063-017-2205-z] - DOI - PMC - PubMed
Sugg 2015 {published data only}
    1. Sugg K, Muller S, Winstein C, Hathorn D, Dempsey A. Does action observation training with immediate physical practice improve hemiparetic upper-limb function in chronic stroke? Neurorehabilitation and Neural Repair 2015;29(9):807-17. [DOI: 10.1177/1545968314565512] - DOI - PubMed
Sun 2016 {published data only}
    1. Sun Y, Wei W, Luo Z, Gan H, Hu X. Improving motor imagery practice with synchronous action observation in stroke patients. Topics in Stroke Rehabilitation 2016;23(4):245-53. - PubMed
Szameitat 2012 {published data only}
    1. Szameitat A, Shen S, Conforto A, Sterr A. Cortical activation during executed, imagined, observed, and passive wrist movements in healthy volunteers and stroke patients. NeuroImage 2012;62(1):266-80. - PubMed
Wright 2014 {published data only}
    1. Wright D, Williams J, Holmes P. Combined action observation and imagery facilitates corticospinal excitability. Frontiers in Human Neuroscience 2014;8:951. - PMC - PubMed
Yun 2011 {published data only}
    1. Yun TW, Lee MK. The change of mu rhythm during action observation in people with stroke. Journal of the Korean Society of Physical Medicine 2011;6(3):361-8.

References to ongoing studies

NCT02235350 {published data only}
    1. NCT02235350. Study on the effectiveness of action observation treatment (AOT) as a rehabilitation tool in acute stroke patients and in chronic stroke patients with apraxia: a randomized controlled trial. clinicaltrials.gov/ct2/show/study/NCT02235350 (first received 9 September 2014). [NCT02235350]
NCT04015271 {published data only}
    1. NCT04015271. Feasibility of action observation and repetitive task practice on upper extremity outcomes in chronic stroke survivors. clinicaltrials.gov/show/NCT04015271 (first received 10 July 2019).
NCT04047134 {published data only}
    1. NCT04047134. Neuroimaging biomarkers toward a personalized upper limb action observation treatment in chronic stroke patients. clinicaltrials.gov/show/NCT04047134 (first received 6 August 2019).
NCT04574687 {published data only}
    1. NCT04574687. Effects of action observation therapy on fine motor skills of upper limb functions in chronic stroke patients. clinicaltrials.gov/show/NCT04574687 (first received 5 October 2020).
NCT04943601 {published data only}
    1. NCT04943601. Action observation therapy for stroke [Effect of action observation exercises with complex tasks on upper limb function in acute stroke]. clinicaltrials.gov/show/NCT04943601 (first received 29 June 2021). [REC/00816]

Additional references

Bassolino 2015
    1. Bassolino M, Sandini G, Pozzo T. Activating the motor system through action observation: is this an efficient approach in adults and children? Developmental Medicine & Child Neurology 2015;57(Suppl 2):42-5. [DOI: 10.1111/dmcn.12686] - DOI - PubMed
Bazzini 2022
    1. Bazzini MC, Nuara A, Scalona E, De Marco D, Rizzolatti G, Avanzini P, et al. The proactive synergy between action observation and execution in the acquisition of new motor skills. Frontiers in Human Neuroscience 2022;16 :793849 . [DOI: 10.3389/fnhum.2022.793849] - DOI - PMC - PubMed
Buccino 2014
    1. Buccino G. Action observation treatment: a novel tool in neurorehabilitation. Philosophical Transactions of the Royal Society B: Biological Sciences 2014;369(1644):20130185. - PMC - PubMed
Chen 2009
    1. Chen HM, Chen CC, Hsueh IP, Huang SL, Hsieh CL. Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke. Neurorehabilitation and Neural Repair 2009;23(5):435-40. - PubMed
Cowles 2012
    1. Cowles T, Clark A, Mares K, Peryer G, Stuck R, Pomeroy V. Observation-to-imitate plus practice could add little to physical therapy benefits within 31 days of stroke: translational randomized controlled trial. Neurorehabilitation and Neural Repair 2012;27(2):173-82. - PubMed
Feigin 2014
    1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 2014;383(9913):245-55. - PMC - PubMed
Fitts 1967
    1. Fitts PM, Posner MI. Human Performance. Belmont: Brooks/Colemann, 1967.
Garrison 2010
    1. Garrison KA, Winstein CJ, Aziz-zadeh L. The mirror neuron system: a neural substrate for methods in stroke rehabilitation. Neurorehabilitation and Neural Repair 2010;24(5):404-12. - PMC - PubMed
Garrison 2013
    1. Garrison KA, Aziz-zadeh L, Wong SW, Liew SL, Winstein CJ. Modulating the motor system by action observation after stroke. Stroke 2013;44(8):2247-53. - PMC - PubMed
GBD 2017
    1. GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurology 2017;16:877–97. [DOI: 10.1016/ S1474-4422(17)30299-5] - PMC - PubMed
Ge 2018
    1. Ge S, Liu H, Lin P, Gao J, Xiao C, Li Z. Neural basis of action observation and understanding from first- and third-person perspectives: an fMRI study. Frontiers in Behavioral Neurosciences 2018;12:283. - PMC - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Hamilton (ON): McMaster University (developed by Evidence Prime), (accessed prior to 15 June 2022). Available at gradepro.org.
Gregor 2021
    1. Gregor S, Saumur TM, Crosby LD, Powers J, Patterson KK. Study paradigms and principles investigated in motor learning research after stroke: a scoping review. Archives of Rehabilitation Research and Clinical Translation 2021;3(2):100-11. [DOI: 10.1016/j.arrct.2021.100111] - DOI - PMC - PubMed
Hardwick 2018
    1. Hardwick RM, Caspers S, Eickhoff SB, Swinnen SP. Neural correlates of action: comparing meta-analyses of imagery, observation, and execution. Neuroscience & Biobehavioral Reviews 2018;94:31-44. [DOI: 10.1016/j.neubiorev.2018.08.003] - DOI - PubMed
Harvey 2009
    1. Harvey RL. Improving poststroke recovery: neuroplasticity and task-oriented training. Current Treatment Options in Cardiovascular Medicine 2009;11(3):251-9. - PubMed
Higgins 2017
    1. Higgins JP, Altman DG, Sterne JA, (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Churchill R, Chandler J, Cumpston MS editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.2.0 (updated June 2017). Cochrane, 2017. Available from www.training.cochrane.org/handbook/archive/v5.2.
Higgins 2022
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from www.training.cochrane.org/handbook.
Huntley 2018
    1. Huntley MK, Muller S, Vallence AM. Corticospinal excitability is modulated by distinct movement patterns during action observation. Experimental Brain Research 2018;236 (4):1067-75 . [DOI: 10.1007/s00221-018-5199-1] - DOI - PubMed
Johansson 2011
    1. Johansson BB. Current trends in stroke rehabilitation. A review with focus on brain plasticity. Acta Neurologica Scandinavica 2011;123(3):147-59. - PubMed
Katan 2018
    1. Katan M, Luft A. Global burden of stroke. Seminars in Neurology 2018;38(02):208-11. [DOI: 10.1055/s-0038-1649503] - DOI - PubMed
Kemmerer 2021
    1. Kemmerer D. What modulates the Mirror Neuron System during action observation? Multiple factors involving the action, the actor, the observer, the relationship between actor and observer, and the context. Progress in Neurobiology 2021;205:102-28. [DOI: 10.1016/j.pneurobio.2021.102128] - DOI - PubMed
Kim 2018
    1. Kim D-H, An D-H, Yoo W-G. Effects of live and video form action observation training on upper limb function in children with hemiparetic cerebral palsy. Technology and Health Care 2018 ;26 (3):437-43. [DOI: 10.3233/THC-181220] - DOI - PubMed
Krakauer 2019
    1. Krakauer JW, Hadjiosif AM, Xu J, Wong AL, Haith AM. Motor learning. Comprehensive Physiology 2019;14(9):613-63 . [DOI: 10.1002/cphy.c170043] - DOI - PubMed
Langhorne 2011
    1. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet 2011;377(9778):1693-702. [DOI: 10.1016/S0140-6736(11)60325-5] - DOI - PubMed
Lieshout 2020
    1. Lieshout EC, de Port IG, Dijkhuizen RM, Visser-Meily JM. Does upper limb strength play a prominent role in health-related quality of life in stroke patients discharged from inpatient rehabilitation? Topics in Stroke Rehabilitation 2020;27(7):525-33. [DOI: 10.1080/10749357.2020.1738662] - DOI - PubMed
Lundquist 2021
    1. Lundquist CB, Nielsen JF, Brunner IC. Predicting hand motor recovery in severe stroke: the role of motor evoked potentials in relation to early clinical assessment. Journal of Stroke and Cerebrovascular Diseases 2021;30(11):106025. [DOI: 10.1016/j.jstrokecerebrovasdis.2021.106025] - DOI - PubMed
Magill 1989
    1. Magill RA. Motor Learning: Concepts and Applications. 3rd edition. Dubuque: Wm C Brown, 1989.
Millar 2021
    1. Millar JD, Van Wijck F, Pollock A, Ali M. International consensus recommendations for outcome measurement in post-stroke arm rehabilitation trials. European Journal of Physical and Rehabilitation Medicine 2021;57(1):61-8. - PubMed
Page 2021
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLOS Medicine 2021;18(3):e1003583. - PMC - PubMed
Peng 2019
    1. Peng T, Zhu J, Chen C, Tai R, Lee C, Hsieh Y. Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke: a systematic review and meta-analysis. Clinical Rehabilitation 2019;33(8):1277-85. [DOI: 10.1177/0269215519839108] - DOI - PubMed
Pollock 2014
    1. Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J, et al. Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No: CD010820. [DOI: 10.1002/14651858.CD010820.pub2] - DOI - PMC - PubMed
Rand 2015
    1. Rand D, Eng JJ. Predicting daily use of the affected upper extremity 1 year after stroke. Journal of Stroke and Cerebrovascular Diseases 2015;24(2):274-83. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.039] - DOI - PubMed
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Ryan 2016
    1. Ryan R, Synnot A, Prictor M, Hill S. Cochrane Consumers and Communication Group Data Extraction Template for Included Studies. cccrg.cochrane.org/author-resources. [DOI: 10.26181/5b57cfd711743] - DOI
Ryan 2021
    1. Ryan D, Fullen B, Rio E, Segurado R, Stokes D, O’Sullivan C. Effect of action observation therapy in the rehabilitation of neurologic and musculoskeletal conditions: a systematic review. Archives of Rehabilitation Research and Clinical Translation 2021;3:1-33. [DOI: 10.1016/j.arrct.2021.100106] - DOI - PMC - PubMed
Sarasso 2015
    1. Sarasso E, Gemma M, Agosta F, Filippi M, Gatti R. Action observation training to improve motor function recovery: a systematic review. Archives of Physiotherapy 2015;5(1):14. [DOI: 10.1186/s40945-015-0013-x] - DOI - PMC - PubMed
Schulz 2010
    1. Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine 2010;8:18. - PMC - PubMed
Small 2012
    1. Small SL, Buccino G, Solodkin A. The mirror neuron system and treatment of stroke. Developmental Psychobiology 2012;54(3):293-310. - PubMed
Tani 2018
    1. Tani M, Ono Y, Matsubara M, Ohmatsu S, Yukawa Y, Kohno M, Tominaga T. Action observation facilitates motor cortical activity in patients with stroke and hemiplegia. Neurosci Res 2018;133:7-14. - PubMed
Timmermans 2010
    1. Timmermans AA, Spooren AI, Kingma H, Seelen HA. Influence of task-oriented training content on skilled arm-hand performance in stroke: a systematic review. Neurorehabilitation and Neural Repair 2010;24(9):858-70. - PubMed
Zhang 2019
    1. Zhang B, Kan L, Dong A, Zhang J, Bai Z, Xie Y, et al. The effects of action observation training on improving upper limb motor functions in people with stroke: A systematic review and meta-analysis. PLOS ONE 2019;14(8):1-13. [DOI: 10.1371/journal.pone.0221166] [e0221166] - DOI - PMC - PubMed
Zhu 2019
    1. Zhu JD, Cheng CH, Tseng YJ, Chou CC, Chen CC, Hsieh YW, et al. Modulation of motor cortical activities by action observation and execution in patients with stroke: an MEG study. Neural Plasticity 2019;30:8481371 . [DOI: 10.1155/2019/8481371] - DOI - PMC - PubMed

References to other published versions of this review

Borges 2015
    1. Borges LR, Melo LP, Fernandes AB, Guerra RO, Campos TF. Action observation for upper limb rehabilitation after stroke. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No: CD011887. [DOI: 10.1002/14651858.CD011887] - DOI - PMC - PubMed
Borges 2018
    1. Borges LR, Fernandes AB, Melo LP, Guerra RO, Campos TF. Action observation for upper limb rehabilitation after stroke. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No: CD011887. [DOI: 10.1002/14651858.CD011887.pub2] - DOI - PMC - PubMed

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