Patterns of Visual Attention During Action Observation in Stroke Rehabilitation: A Feasibility and Exploratory Study.

Background: Action observation (AO) has emerged as a potentially powerful therapeutic tool to improve stroke rehabilitation. What remains unclear are the underlying visual attention mechanisms that inform gaze strategies during AO. Further, it is unclear whether visual attention is sustained during AO or influenced by the severity of residual functional impairments following stroke.

Objective: This study seeks to explore eye gaze patterns and vigilance during a single session of AO in stroke survivors with varying levels of impairment.

Methods: Twenty stroke survivors with upper limb impairment (Fugl-Meyer Scores ranging 23-54) engaged in AO by watching an actor performing a disc placement task (observation phase), followed by the participant performing the task (execution phase) with their more affected, then less affected limb. Gaze patterns during the observation phase were evaluated for areas of most prominent gaze and compared between varying levels of severity of residual limb impairment.

Results: Gaze during AO prior to movement on the more affected side is focused on hand and object while AO prior to movement on the less affected side is focused on the overall action in the video. These patterns are prevalent for all levels of severity.

Conclusions: This suggests that participants are developing gaze patterns in line with optimal approaches to encode action specifics, especially on the more affected side. This presents valuable understanding of perceptual patterns of AO that may be optimal for studies evaluating AO in stroke.