Volume 35, Issue 1 (1-2021)                   Med J Islam Repub Iran 2021 | Back to browse issues page


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Shamili A, Hassani Mehraban A, Azad A, Raissi G R, Shati M, Farajzadeh A. Effectiveness of Self-Action Observation Therapy as a Novel Method on Paretic Upper Limb and Cortical Excitability Post-Stroke: A Single-Subject Study. Med J Islam Repub Iran 2021; 35 (1) :1360-1369
URL: http://mjiri.iums.ac.ir/article-1-7477-en.html
Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran , azad.a@iums.ac.ir
Abstract:   (1052 Views)
    Background: Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient.
   Methods: A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study.  In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases.
   Results: Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis.
   Conclusion: Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.
 
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Type of Study: Original Research | Subject: Rehabilitation

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