NITTE Institute of Physiotherapy, NITTE University, India.
Department of Health Services, Ministry of Health and Population, Government of Nepal.
J Nepal Health Res Counc. 2024 Mar 22;21(3):400-409. doi: 10.33314/jnhrc.v21i3.4471.
Video-demonstrated action-observation-execution is an effective intervention for motor re-learning in stroke rehabilitation. But customization of video for each task repeatedly questions its feasibility within limited resources, particularly for daily routine practice and in community settings. Physiotherapist-demonstrated action-observation-execution is a practical intervention based on the principle of observation and consecutive repetitions of observed real, live movements. The main objective of this study was to investigate the immediate effect of Physiotherapist-demonstrated action-observation-execution in upper extremity motor training in stroke.
Individuals with stroke were screened and 5 eligible participants were recruited. The research was a pre-post. A single session of Physiotherapist-demonstrated action-observation-execution was administered. A functional "Drinking" task was subdivided into simpler acts and trained. Pre and post intervention assessment of movement time using five hand-and-arm items of Nepali Wolf Motor Function Test were carried out. Global recovery was assessed in the form of Visual Analogue Scale.
Paired t-test provided statistically significant difference in total movement time (mean difference=5.04 seconds, standard deviation=1.92, p=0.004) with larger effect size (0.95) indicating impressive improvement in movement time with the training. Substantial difference in global recovery score was noted (mean difference=17.40, standard deviation=3.65, p<0.0001, effect size=1.00) signifying the increased confidence and improved performance of upper extremity post treatment.
The findings indicated that Physiotherapist-demonstrated action-observation-execution could be a feasible intervention to train motor functions in participants with stroke. Large-scale studies are recommended to establish the effectiveness of the intervention.
视频演示的动作观察执行是一种有效的中风康复运动再学习干预措施。但是，为每个任务定制视频，在资源有限的情况下，反复质疑其可行性，尤其是在日常常规练习和社区环境中。治疗师演示的动作观察执行是一种基于观察和连续重复观察到的真实、生动动作的实用干预措施。本研究的主要目的是探讨治疗师演示的动作观察执行在上肢运动训练中的即时效果。
对中风患者进行筛选，招募了 5 名合格的参与者。研究采用前后对照设计。进行了一次治疗师演示的动作观察执行治疗。将一项功能“饮水”任务细分为更简单的动作并进行训练。使用尼泊尔沃尔夫运动功能测试的五个手和手臂项目评估干预前后的运动时间。以视觉模拟量表的形式评估整体恢复情况。
配对 t 检验显示总运动时间存在统计学显著差异（平均差异=5.04 秒，标准差=1.92，p=0.004），具有较大的效应量（0.95），表明训练后运动时间有显著改善。整体恢复评分也有明显差异（平均差异=17.40，标准差=3.65，p<0.0001，效应量=1.00），表明治疗后上肢的信心和表现都有所提高。
研究结果表明，治疗师演示的动作观察执行可能是一种可行的干预措施，可用于训练中风患者的运动功能。建议进行大规模研究以确定该干预措施的有效性。
