Action Observation Therapy for Enhancing Motor Recovery in Stroke Induced Apraxia

Dhanusia S.; J. Mohanasundaram; Prathap Suganthirababu; Priyadharshini K.; Vignesh Srinivasan

doi:10.15391/prrht.2025-10(4).03

Authors

Dhanusia S. Department of Neuroscience, Saveetha college of Physiotherapy, Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India https://orcid.org/0000-0003-2164-078X
J. Mohanasundaram Department of Neuroscience, Saveetha college of Physiotherapy, Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India https://orcid.org/0009-0006-1465-009X
Prathap Suganthirababu Department of Neuroscience, Saveetha college of Physiotherapy, Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India https://orcid.org/0000-0002-1419-266X
Priyadharshini K. Department of Neuroscience, Saveetha college of Physiotherapy, Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India https://orcid.org/0000-0002-8121-2640
Vignesh Srinivasan Department of Neuroscience, Saveetha college of Physiotherapy, Saveetha Institute of Medical and Technical Science, Chennai, Tamil Nadu, India https://orcid.org/0000-0003-3378-4334

DOI:

https://doi.org/10.15391/prrht.2025-10(4).03

Keywords:

Action Observation Therapy, Ideomotor Apraxia, Mirror Neuron System, Apraxia Screen of TULIA, Fugl Meyer Assessment of Upper Extremity

Abstract

Purpose. Ideomotor apraxia (IMA), a common consequence of stroke, impairs the ability to perform purposeful movements despite preserved motor strength and understanding of the task. Conventional rehabilitation approaches often yield limited recovery in these patients. Recent research has highlighted the potential of Action Observation Therapy (AOT) as a novel, neurorehabilitative strategy leveraging the mirror neuron system to promote motor relearning. This study explores the efficacy of Action Observation Therapy in enhancing motor recovery in patients with stroke induced ideomotor apraxia.

Material & Methods. A randomized controlled trial was conducted involving 40 stroke patients diagnosed with IMA. Participants were randomly assigned to groups A and B, each consisting of 20 people, using the sealed envelope method in accordance with the inclusion and exclusion criteria. AOT and conventional therapy were given to the experimental group, whereas conventional therapy was given to the control group. The therapy session was conducted for 40 minutes daily, 4 times a week, over a span of 6 weeks. Assessments were performed pre- and post-intervention using Apraxia Screen of TULIA (AST) and Fugl Meyer Assessment of Upper Extremity (FMA-UE).

Results. Patients in the group A demonstrated statistically significant improvements in upper limb function compared to the group B. A notable difference was found in the post-test mean and standard deviation values for AST in Group A [10.20±0.768] and Group B [7.90±0.788], as well as for FMA-UE in Group A [59.65±3.216] and Group B [52.75±4.191], with a p-value less than 0.001.

Conclusions. Action Observation Therapy offers a promising, non-invasive intervention for improving motor function in individuals with stroke-induced ideomotor apraxia. The findings support the integration of AOT into conventional rehabilitation protocols to harness neural plasticity and enhance motor recovery.

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