Efficacy of Action Observation Therapy on Gait, Balance and Mobility Impairments: A Systematic Review and Meta-Analysis.

IF 1.5 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2025-01-01 DOI:10.1002/pri.70006

Michela Picardi, Federico Temporiti, Chiara Salamone, Peppino Tropea, Giovanni Buccino, Massimo Corbo, Roberto Gatti

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引用次数: 0

Abstract

Background and purpose: Action Observation Therapy (AOT) has been proposed to improve gait, balance and mobility in subjects with neurological and musculoskeletal disorders. The current review aimed to investigate AOT effects in subjects with gait, balance and mobility impairments.

Methods: A systematic literature search was performed using PubMed/MEDLINE, EMBASE and Scopus databases from inception until May 2023. Randomized controlled trials investigating effects of AOT on gait, balance and mobility in subjects with any type of clinical condition were included. Two reviewers performed data extraction and methodological quality assessment using the revised Cochrane risk of bias tool for randomized trials. The overall effects were reported as mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI).

Results: Thirty-one studies were included. Low evidence supported AOT to enhance walking speed (SMD: 0.40; 95% CI: 0.17, 0.62; I² = 0%), stride length (SMD: 0.35; 95% CI 0.05, 0.66; I² = 0%) and single limb support duration (MD: 4.1%; 95% CI: 1.0, 7.2, I² = 0%) after stroke. Low evidence supported AOT to improve walking distance (MD: 56.8 m; 95% CI; 39.2, 74.4 m) and dynamic (SMD: 0.40; 95% CI: 0.04, 0.76; I² = 0%) and static (SMD: 0.69; 95% CI: 0.32, 1.05; I² = 0%) balance, while very low evidence supported AOT to enhance mobility (MD: -1.48 s; 95% CI; -2.2, -0.8 s; I² = 0%) after stroke. Moderate evidence supported AOT to improve dynamic balance in subjects with Parkinson's disease (SMD: 0.44; 95% CI: 0.09, 0.79; I² = 28%), while low evidence supported AOT to enhance dynamic balance (SMD: 0.61; 95% CI: 0.15, 1.08; I² = 27%) and mobility (MD: -2.08 s; 95% CI; -3.5, -0.6 s; I² = 0%) in patients with orthopedic conditions.

Conclusion: AOT improved gait, balance and mobility after stroke, dynamic balance in patients with Parkinson's disease and dynamic balance and mobility in patients with orthopedic conditions. However, evidence certainty was generally low and further high-quality studies are needed.

Trial registration: PROSPERO International Prospective Register of Systematic Reviews (n. CRD42021240626).

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行动观察疗法对步态、平衡和行动障碍的疗效：系统回顾与元分析》。

背景和目的：行动观察疗法（AOT）被认为可以改善神经和肌肉骨骼疾病患者的步态、平衡和活动能力。本综述旨在研究行动观察疗法对步态、平衡和行动障碍患者的影响：方法：使用 PubMed/MEDLINE、EMBASE 和 Scopus 数据库对从开始到 2023 年 5 月的文献进行了系统性检索。研究 AOT 对任何临床症状的受试者的步态、平衡和活动能力的影响的随机对照试验均被纳入其中。两名审稿人使用修订版科克伦随机试验偏倚风险工具进行了数据提取和方法学质量评估。总体效果以平均差（MD）或标准化平均差（SMD）及 95% 置信区间（CI）的形式进行报告：结果：共纳入 31 项研究。低度证据支持 AOT 可提高中风后的行走速度（SMD：0.40；95% CI：0.17，0.62；I2 = 0%）、步长（SMD：0.35；95% CI：0.05，0.66；I2 = 0%）和单肢支持持续时间（MD：4.1%；95% CI：1.0，7.2，I2 = 0%）。低度证据支持 AOT 可改善步行距离（MD：56.8 米；95% CI：39.2，74.4 米）、动态（SMD：0.40；95% CI：0.04，0.76；I2 = 0%）和静态（SMD：0.69；95% CI：0.32，1.05；I2 = 0%）平衡，而极低度证据支持 AOT 可提高中风后的移动能力（MD：-1.48 秒；95% CI：-2.2，-0.8 秒；I2 = 0%）。中度证据支持AOT可改善帕金森病患者的动态平衡（SMD：0.44；95% CI：0.09，0.79；I2 = 28%），而低度证据支持AOT可提高骨科患者的动态平衡（SMD：0.61；95% CI：0.15，1.08；I2 = 27%）和活动能力（MD：-2.08 s；95% CI；-3.5，-0.6 s；I2 = 0%）：AOT改善了中风后的步态、平衡和活动能力，改善了帕金森病患者的动态平衡，改善了骨科疾病患者的动态平衡和活动能力。然而，证据的确定性普遍较低，需要进一步开展高质量的研究：试验注册：PROSPERO 国际系统综述前瞻性注册（编号：CRD42021240626）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.