Application of Action Observation Therapy in Swallowing Rehabilitation: A Randomised Controlled Study

Background: Action Observation Therapy (AOT) has emerged as a potential neurorehabilitation therapy to promote motor control for individuals with neurological dysphagia (ND), facilitating neural plasticity through activation of the mirror nervous system. Objective: The aim of this study was to investigate the effect of AOT-based dysphagia rehabilitation on suprahyoid (SH) muscle activation, swallowing difficulties, swallowing function, depressive symptom and quality of life in ND patients. Methods: Thirty-four participants with ND were randomly allocated to the AOT group (n = 17) or control group (n = 17). All participants underwent a 4-week (5 sessions per week) conventional swallowing therapy. The AOT group watched exercise videos before doing these exercises, and the control group performed the same exercises without the videos. Surface electromyographic (sEMG) activation of suprahyoid muscles, Eating Assessment Tool 10 Turkish Version (T-EAT 10) and Swallowing Ability and Function Evaluation (SAFE) for swallowing difficulties and swallowing function, Swallow Quality of Life Questionnaire (SWAL-QOL) and Beck Depression Inventory (BDI) for quality of life and depressive symptom severity were evaluated. Results: Post-treatment SH amplitude level and T-EAT-10 scores were significantly lower in the AOT group compared to the control group (p = 0.001, p = 0.012). There was a significant improvement in SAFE after treatment in the AOT group (p < 0.05); however, there was no significant difference between the two groups (p > 0.05). Both groups showed similar improvement in quality of life and depression. Conclusion: This study showed that AOT can be a good option for improving the SH muscle activation and dysphagia difficulties in ND patients. Trial Registration identifier: NCT05782790