Feasibility of Action Observation and Repetitive Task Practice on Upper Extremity Outcomes in Chronic Stroke Survivors

The Feasibility of Action Observation and Repetitive Task Practice Combined Practice Schedule on Upper Extremity Outcomes in Moderately Impaired Chronic Stroke Survivors

The objective of this pilot randomized controlled single blinded, parallel-group study is to detect change of the Action Observation (AO) and Repetitive Task Practice (RTP) combined practice schedule on upper limb motor impairment outcomes in chronic, moderately impaired stroke survivors.

The current proposal aims to conduct a pilot randomized controlled single blinded, parallel-group study design to detect change of the Action Observation (AO) and Repetitive Task Practice (RTP) combined practice schedule on upper limb (UL) motor impairment outcomes in the chronic, moderately impaired stroke survivor. Individuals will be randomized to 1) experimental conditions of AO + RTP practice schedule, or 2) control condition of Placebo Video (PV) + RTP, and will receive an assigned regimen from a blinded intervention therapist for one hour, 3 times per week, for 8 weeks (total of 24 sessions), and a daily 30 minute HEP. A blinded assessor will complete assessments on each subject at three distinct time points of pretest, post intervention, and 1 month post intervention.

Inclusion Criteria:

• Experienced a stroke resulting in a Upper Extremity Fugl Meyer score >17 < 49
• Experienced a post stroke > 6 months
• > 24 on the Folstein Mini Mental Status Examination
• Experienced only one stroke
• Discharged from all forms of physical rehabilitation intervention
• Visual acuity of 20/50 or greater with or without corrective lenses
• > 19 on the Hooper Visual Organization Test
• Unilateral stroke only
• Cerebral stroke
• Age of onset of stroke greater than 18 years old.

Exclusion Criteria:

• < 18 years old
• > 5 on a 10-point visual analog pain scale in the affected UL
• > 2 on the Modified Ashworth Scale in the affected UL to exclude individuals with hypertonia, spasticity, joint rigidity, and joint contracture
• Participating in any experimental rehabilitation or drug studies
• Uncontrolled cardiovascular, or pulmonary disease, or other disease that would preclude involvement in a therapeutic treatment
• Neurological disorder other than stroke
• > 31 on Beck Depression Inventory ("Severe Depression")
• Unable to regularly attend treatment sessions and follow-up due to distance from the center or inadequate social support
• Cerebellar stroke with ataxia