# Could Combined Action Observation and Motor Imagery Practice, Added to Standard Rehabilitation, Improve Study Upper Limb Functional Recovery in Chronic Stroke Patients? Suggestive Evidence from a Feasability Study

## TL;DR

A small study suggests combining action observation and motor imagery with standard therapy may improve upper limb recovery in chronic stroke patients.

## Contribution

This is the first feasibility study to suggest that adding action observation and motor imagery to standard rehabilitation may enhance recovery in stroke patients.

## Key findings

- Patients receiving action observation and motor imagery showed greater improvement in upper limb function than those receiving only conventional therapy.
- The study highlights the potential of combining action observation and motor imagery with standard rehabilitation for stroke recovery.
- However, the small sample size and lack of follow-up limit the generalizability and long-term conclusions.

## Abstract

This study aims to investigate whether a combined action observation–motor imagery practice may enhance the effects of conventional physical rehabilitation in a stroke survivor population. A total of 8 (7 male, 1 female) post-stroke patients with upper limb hemiparesis were enrolled into a single-blinded, randomised, study. Five times per week for three weeks, four patients experienced 60’ conventional physical therapy, while the other 4 experienced 30’ conventional physical therapy and 30’ action observation–motor imagery practice. The Fugl-Meyer Assessment-Upper Extremity and the Wolf Motor Function Test scores from the baseline and post-physiotherapy were used to evaluate upper extremity motor function. Patients who received the AO + MI alongside conventional physical rehabilitation benefitted more than those who received only conventional physical rehabilitation. However, the sample size was very small (only eight participants), which reduces both the statistical power and the ability to generalise the results. Moreover, there was no follow-up; therefore, it is unclear whether the observed improvements lasted over time. Finally, some potentially confounding factors, such as stroke type or lesion site, were not statistically controlled. Notwithstanding these limitations, our findings may serve as a basis for future large-scale, well-controlled studies on AO + MI in stroke rehabilitation.