Application of action observation therapy in stroke rehabilitation: A systematic review

BACKGROUND: Numerous studies have described the positive effects of action observation therapy (AOT) on motor recovery among patients with stroke. However, there is no standardized procedure for when and how to intervene with AOT. OBJECTIVES: Thus, we reviewed and analyzed previous studies to provide a guideline for the application of AOT in stroke rehabilitation. METHOD: We searched PubMed, Cochrane Library, and EMBASE from inception to October 31 2022, using title and abstract search terms of “action observation” and “stroke” or “hemiplegia.” Of 4108 potential articles, 29 articles (sample size = 429 in AOT groups; sample size = 423 in control groups) that met inclusion criteria were included in final analyses. RESULTS: The results suggested starting adjuvant AOT > 23 days after stroke onset and conducting 30–40 min/session, 3–5 times/week for at least 4 weeks. CONCLUSION: Based on our results, many factors will impact the effect of AOT on stroke rehabilitation, when to apply (timing) and how to apply (frequency, single, and total duration) should be fully considered when applying AOT as adjuvant therapy in stroke rehabilitation.