Objective: This systematic review summarizes all published outcomes of Parkinson’s patients treated with AOT.

Background: Gait disorders in patients with Parkinson’s disease (PD) are caused by a complex interplay between motor, cognitive, and affective factors, rather than being pure motor phenomena. Among attentional strategies, action observation training (AOT) is a top-down rehabilitation approach exploiting the ‘‘mirror’’ mechanism and its potential role in motor recovery through motor learning consolidation.

Method: Eligible criteria were identified through five electronic databases (PubMed, WOS, Scopus, PEDro, and Cochrane) that were searched by two independent reviewers up to 10 January 2023 to select randomized controlled trials . An eligibility screening in the form of title and abstract screening and then full-text screening were performed. Any article with any language rather than English was excluded. All outcome measures were evaluated, and data from included articles were extracted.

Results: Six studies met the inclusion criteria with 202 patients. The severity of the disease was assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS) in three studies and the Hoehn and Yahr scale in two studies. For the quality of life assessment, the Parkinson’s Disease Questionnaire-39 (PDQ-39) was used in four studies, three of them found that there was a significant difference between groups in favor of the AOT group (p<0.05).  Also, four studies assessed the freezing of gait episodes among the patients with the Freezing of Gait Questionnaire (FoG-Q) and three of them found that there was a significant difference between groups in favor of the AOT group (p<0.05). Functional measures were evaluated in three studies including Timed Up and Go test (TUG), 10 Meters Walking Test (10M-WT), and Berg Balance Scale (BBS). Regarding Both TUG and 10M-WT, there was a significant difference between groups in favor of the AOT group (p<0.05) in the two studies. While BBS was significantly improved in ATO than the compared group in all of the three studies (p<0.05).

Conclusion: Action observation training could be useful and effective rehabilitation for the treatment of Parkinson’s patients mainly for improving walking ability, quality of life, and typical motor signs like freezing of gait, but further randomized clinical trials with larger sample sizes are still necessary to be conducted.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-systematic-review-of-action-observation-therapy-for-parkinsons-disease-rehabilitation/