Objective: The aim of this study was to verify the feasibility of a home-based AOT in improving balance and gait problems in a cohort of PD subjects. Furthermore, we investigated long-lasting effects in terms of functional improvements and QoL.

Background: Parkinson’s disease (PD) is expected to impose an increasing social and economic burden all over the world. In fact, even with optimal medical management, PD subjects experience a deterioration of mobility and independence in daily activities, leading to reduced quality of life (QoL). There has been increasing demand to consider rehabilitation as an essential adjuvant to pharmacological treatment. Action Observation Therapy (AOT) has been recently described as an effective strategy in PD rehabilitation, promoting neural plasticity and motor learning.

Method: 55 subjects with PD (age 70.4 ± 5.0, HY stage 1-3) were enrolled in this study. Participants were invited to perform AOT at home for 8 weeks (5 days/week) using a tablet. In each training sessions, they were required to watch video sequences of exercises and then to repeat the same actions for 3 minutes. In all, 20 videos were used in 2 months of training. Motor and cognitive performance and QOL were measured by means of: Timed UP&GO (TUG), 10-meter (10mwt), 6 minutes walking tests (6Mwt), Berg Balance Scale (BBS), Montreal Cognitive Assessment (MOCA), Freezing of gait and PDQ-39 questionnaires. Assessment points were set at one week before (T0), 1 month (T1), 2 months (T2) and at 6 months (T3) after AOT training.

Results: 46 participants completed the training and 3 didn’t complete the T3 evaluation, thus 43 subjects were included in the analysis. Statistical analysis showed significant improvements in gait and balance performance (TUG, 10mwt, BBS, FoG-Q, p always<0.05) and in QoL (p<0.05) at T1 and T2 evaluations. Most of these results (except FoG-Q and 6Mwt) remained also significant at follow-up evaluation (T3). Furthermore, we found a significant increase of MoCA and PDQ-39 scores at all assessments.

Conclusion: Unsupervised training combining exercises with AO in a cohort of PD is feasible and lead to beneficial effect on motor performance, with positive impact on global cognition and QoL. This finding might provide a support for introducing AOT as a valid and user-friendly tool for home-based training.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-the-use-of-home-based-action-observation-training-in-subjects-with-parkinsons-disease/