Effect of Action Observation Therapy on Functional Recovery in Patients with Neurological Disorders: A Systematic Review
Hrushikesh Ashok Mangave, Suvarna Shyam GanvirAbstract
Background:
Action observation therapy (AOT), grounded in mirror neuron system theory, has emerged as a promising neurorehabilitation approach for enhancing motor and cognitive outcomes. By observing goal-directed actions, patients engage neural circuits related to movement execution, promoting neuroplasticity. While conventional therapy targets physical performance, AOT may offer superior benefits in neurological disorders. However, variations in study design, intervention protocols, and outcome measures warrant a systematic evaluation of the effectiveness of AOT.
Methods:
A systematic review was conducted using PubMed and Google Scholar databases (2018–2025), adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) involving AOT for individuals with neurological conditions were included. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Outcome measures related to motor, functional, balance, swallowing, and cognitive domains were extracted and analyzed.
Results:
A total of 18 RCTs met the inclusion criteria. Most studies used video-based AOT; others used live observation, virtual reality, or home-based platforms. Across studies, AOT significantly improved upper limb function, gait, balance, and activities of daily living. Enhanced outcomes were observed when AOT was combined with motor imagery or functional electrical stimulation. In CP, live and home-based AOT formats were both effective. For PD, mixed results were reported for balance and gait, but Tai Chi-based AOT showed promise. In mild cognitive impairment and Wallenberg syndrome, AOT improved cognitive and swallowing functions, respectively. The methodological quality ranged from moderate to high, with newer studies demonstrating better blinding and reporting practices.
Conclusion:
AOT is a versatile, low-cost, and effective adjunct to conventional rehabilitation, particularly for improving motor function across various neurological conditions.