Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial

Purpose: To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. Design: Randomized, controlled pilot study. Setting: Inpatient rehabilitation hospital. Subjects: A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group (n = 12) or control group (n = 13). Intervention: Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. Main measures: Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. Results: Changes in the values for the 10-m walk test (0.17 +/- 0.19 m/s vs. 0.05 +/- 0.08 m/s), community walk test (-151.42 +/- 123.82 seconds vs. 67.08 +/- 176.77 seconds), and activities-specific balance confidence (6.25 +/- 5.61 scores vs. 0.72 +/- 2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 +/- 11.34 cm vs. 3.16 +/- 11.20 cm), single support (5.87 +/- 5.13% vs. 0.25 +/- 5.95%), and velocity (15.66 +/- 12.34 cm/s vs. 2.96 +/- 10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. Conclusions: Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.