This study will be conducted to evaluate the outcomes of action observation therapy on fine motor skills of affected upper limb among patients with chronic stroke.

The data for study will be collected for the duration of 5 months, data will be collected at 1st, 4th, 8th, 12th and then at 16th week of follow up. It is a Randomized Control Trial. Patients will be selected by Consecutive Sampling from Ittefaq Hospital Trust, Lahore. All patients were right handed prior to stroke. Screening tools used will be Canadian Neurological Scale, the Mini-Mental State Examination (MMSE), the Bell Barrage test, and the ideomotor apraxia test (SpinnlerRognoni).Tests for assessment will be Fugl-Meyer test (FM) (of the upper limb), Frenchay Arm test (FAT), Box and Block test (BBT), Modified Ashworth Scale (AS) and Functional Independence Measure Motor items (FIMM). The SPSS version 21 will be used for analyzing data. The descriptive data will be expressed in Frequency and Percentages, while within the group differences will be measured by Mixed Model Anova.

Inclusion Criteria:

• First-ever stroke,
• Enrolled 6 months after the event onset with ischemia or primary hemorrhage.
• All patients were right handed prior to stroke.

Exclusion Criteria:

• Posterior circulation infarction,
• Subarachnoid hemorrhage,
• Severe forms of neglect and anosognosia (number of errors in Bell Barrage test≥15)
• Impaired comprehension (Token test score ≤ 17)
• History of endogenous depression or serious psychiatric disorders, and
• Severe visual deficits (restricting the access to visual stimuli).