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NCT Number: NCT06166862

Action Observation and Motor Imagery Therapy in Stroke

In recent years, motor imagery (MI) and action observation (AO) therapy strategies have been used in rehabilitation programs to increase motor learning in stroke. Visuomotor training strategies such as AO and MI therapy rely on the activity of the mirror neuron system to facilitate motor re-learning. Mirror neurons are activated during the performance of goal-directed actions, also when observing the same action and visualizing the action in the mind.

This clinical trial aims to test whether the application of AO and MI treatment in stroke in addition to conventional rehabilitation programs has an additional effect on motor recovery, activities of daily living, and quality of life.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Vascular Diseases

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Stroke is one of the most common neurological disorders that causes chronic disability in adulthood. Stroke-related neurological dysfunction causes impairment in motor and sensory skills and limitation in the ability to perform daily living activities, resulting in decreased independence of patients. This process causes significant impairment in the quality of life of stroke patients.

In recent years, motor imagery (MI) and action observation (AO) therapy strategies have been used in rehabilitation programs to increase motor learning in stroke. Visuomotor training strategies such as AO and MI therapy rely on the activity of the mirror neuron system to facilitate motor re-learning. Mirror neurons are activated during the performance of goal-directed actions, also when observing the same action and visualizing the action in the mind.

This clinical trial aims to test whether the application of AO and MI treatment in stroke in addition to conventional rehabilitation programs has an additional effect on motor recovery, activities of daily living, and quality of life.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients who had a stroke in the last year
  • Functional Ambulation Classification score 2-5

Exclusion criteria

  • Patients who have had repeated strokes
  • Patients with neglect
  • Patients with cognitive dysfunction (those who cannot follow simple verbal instructions)
  • Patients with severe hearing problems
  • Patients with severe vision problems
  • Patients with additional musculoskeletal system pathology that will affect physical performance (such as amputation, severe joint mobility limitation, peripheral nerve damage)
  • Patients with uncontrolled hypertension and diabetes mellitus
  • Patients with a history of symptomatic lung disease (such as asthma, chronic obstructive pulmonary disease, emphysema)
  • Patients with a history of symptomatic cardiac disease (such as coronary artery disease, arrhythmia, heart failure)
  • Patients with peripheral artery disease

Treatment and study plan

Action observation and motor imagery therapy for rehabilitation

Other

Action observation; Patients will watch some exercises accompanied by music from a previously prepared video for 10 minutes. Exercises include 8-10 repetitions of abduction-adduction, horizontal abduction-adduction, flexion-extension and supination-pronation movements for the upper extremity, and stepping, forward-backward stepping, side stepping and ankle dorsiflexion movements for the lower extremity.

Motor imagery training; Patients will be asked to visualize the actions they watched in their minds for 10 minutes.

Then the patients will watch the video again and will be asked to perform the exercises while watching.

Sham action observation and motor imagery therapy for rehabilitation

Other

Sham action observation; Patients will watch a video consisting of static nature photographs for 10 minutes with the same music.

Sham motor imaginary; Patients will think about the video they watched for 10 minutes.

Then, they will watch another video in which the exercises are performed only once, and they will be asked to do the exercises. They will be given enough time to do 8-10 repetitions.

Primary outcomes

  1. The difference in the scores of the Fugl-Meyer Assessment between pre- and post-rehabilitation assessments

    Time frame: 6 weeks

    Univariate statistical analyses will be performed to calculate differences in the scores of the Fugl-Meyer Assessment between pre- and post-rehabilitation assessments.

    The Fugl-Meyer Assessment is a stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia. The motor domain is used in this study, which includes items assessing movement, coordination, and reflex action of the upper and lower extremities. Motor score ranges from 0 (hemiplegia) to 100 points (normal motor performance). Divided into 66 points for upper extremity and 34 points for the lower extremity.

  2. The difference in the scores of the Brunnstrom stages between pre- and post-rehabilitation assessments

    Time frame: 6 weeks

    Univariate statistical analyses will be performed to calculate differences in the scores of the Brunnstron stages between pre- and post-rehabilitation assessments.

    Brunnstrom staging assesses the motor recovery process of the hemiplegic patient in 6 stages (Stages 1 to 6). Upper extremity, lower extremity, and hand are evaluated separately. Higher stages indicate better motor function.

Secondary outcomes

  1. The difference in the scores of the Barthel Index between pre- and post-rehabilitation assessments

    Time frame: 6 weeks

    Univariate statistical analyses will be performed to calculate differences in the scores of the Barthel Index between pre- and post-rehabilitation assessments.

    The Barthel Index measures the functional independence of a person in mobility and activities of daily living. The index yields a total score out of 100 (0 to 100). The higher the score, the greater the degree of functional independence.

  2. The difference in the scores of the Stroke-Specific Quality of Life Scale between pre- and post-rehabilitation

    Time frame: 6 weeks

    Univariate statistical analyses will be performed to calculate differences in the scores of the Stroke-Specific Quality of Life Scale between pre- and post-rehabilitation assessments.

    Stroke Specific Quality of Life Scale assesses health-related quality of life specific to stroke survivors. It consists of a total of 49 items and the total score ranges from 49-245. Higher scores indicate better functioning.

Study contacts

Contact information is provided by the study sponsor or research team.

Aynur Basaran, MD, Prof.

CONTACT

[email protected]

Yurdagul Bahran Mustu, MD.

CONTACT

[email protected]

+90 506 209 76 72

Sponsors and collaborators

Lead sponsor

Karamanoğlu Mehmetbey University

Other

Collaborators

  • Karaman Training and Research Hospital

Registry information

Official study title

Effect of Action Observation and Motor Imagery Therapy on Balance, Functional Status and Quality of Life in Stroke, Randomized Controlled Trial

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Dec 12, 2023
Registry last updated
Dec 11, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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