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CompletedNCT06794749Updated Feb 4, 2026

Action Observation Therapy in Chronic Stroke

An interventional study of Action Observation Therapy and Control in Stroke, sponsored by Karabuk University. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-04.

Sponsored by Karabuk University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
26
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Functional impairment in the upper extremities is one of the most common sequelae in stroke patients. It significantly limits the patients' grasping-releasing functions and, consequently, their activities of daily living (ADL), such as eating - drinking, dressing, and self-care. Action Observation Training (AOT), performed by observing simple actions frequently used in ADL and then imitating the observed actions, reduces interhemispheric inhibition and allows the elimination of impairments in upper extremity motor function and relearning of functions in chronic stroke patients. This study aims to investigate the effects of telerehabilitation and face-to-face AOT application on upper extremity functions, activities of daily living, and quality of life in chronic stroke patients and to question whether there are differences between the short- and long-term effects of these two AOT applications.

Read the detailed description

Stroke is defined as a neurological picture caused by focal damage to the central nervous system due to vascular problems such as cerebral infarction or intracerebral or subarachnoid hemorrhage.

Functional impairment in the upper extremities is one of the most common sequelae in stroke patients. It significantly limits the patients' grasping-releasing functions and, consequently, their activities of daily living (ADL), such as eating - drinking, dressing, and self-care.

Action Observation Therapy (AOT), which is performed by observing simple actions frequently used in ADL and then imitating the observed actions, is a rehabilitation approach used in recent years to improve upper limb functions in the rehabilitation of stroke and various neurological diseases. It is stated that AOT reduces interhemispheric inhibition and allows the elimination of impairments in motor function and relearning of functions.

Telerehabilitation is the remote delivery of rehabilitation services through telecommunication technology. Telerehabilitation provides important advantages, such as difficulty transferring the patient to the health center, where the rehabilitation process takes a long time, travel time, and travel costs in stroke patients.

In the literature review, no study was found comparing the effect of the AOT with the telerehabilitation method and face-to-face application on the patient's upper extremity functions, activities of daily living, and quality of life in the rehabilitation of patients with chronic stroke. In addition, to our knowledge, there is no study examining the long-term effects of AOT, which has been the subject of a limited number of studies.

02

Conditions studied

  • Stroke

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03

In context

Stroke

7,286 studies on the registry are indexed under Stroke; 2,007 are open to participants now.

This study's enrollment of 26 is below the median of 50 across 5,369 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Karabuk University is the lead sponsor of 126 studies on the registry; 30 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Being over 18 years of age,
  • Diagnosis of left hemiparetic stroke,
  • Having passed between 6-36 months since the onset of stroke,
  • Being in stage 4 or 5 of the hand and stage 4, 5 or 6 of the upper extremity according to Brunnstrom staging,
  • Being able to sit on a chair for 30 minutes without support (patients who scored 20 or more points in total from the Trunk Impairment Scale),
  • Scoring 24 or more points from the Mini Mental Test

Exclusion criteria

Exclusion Criteria:

  • Not volunteering to participate in the study,
  • Having spasticity (level 3 and 4 according to the Modified Ashworth Scale) that prevents grasping and releasing an object,
  • Having contracture in any of the upper extremity joints on the affected side,
  • Having a serious neglect disorder (scoring 21 and above on the Catherine Bergego Scale),
  • Having cooperation, adaptation and behavioral disorders during the application of the tests used to obtain the data,
  • Having mental impairment that prevents communication and receiving basic commands (scoring less than 24 on the Mini Mental Test)
  • Having additional neurological and/or orthopedic problems that may affect motor performance and sitting balance
  • Having advanced vision and hearing problems (if any, these problems have not been corrected with assistive devices such as glasses, lenses, hearing aids, etc.)
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
26 participants (actual)

Study arms

  • Experimental
    Action Observation Therapy

    Patients received action observation therapy in addition to general physiotherapy via telerehabilitation method, 3 days a week for 5 weeks.

    Other: Action Observation Therapy

  • Active comparator
    Control

    Patients received general physiotherapy in addition to face-to-face action observation treatment 3 days per week for 5 weeks.

    Other: Control

Interventions

  • OtherAction Observation Therapy

    Patients received general physiotherapy in addition to action observation therapy (AOT) via telerehabilitation method for 5 weeks, 3 days a week. AOT was applied to patients as a single session per day and lasted 30 minutes. General physiotherapy session was applied face to face for 45 minutes.

  • OtherControl

    Patients received general physiotherapy in addition to action observation therapy (AOT) via face-to-face telerehabilitation method for 5 weeks, 3 days a week. AOT was applied to patients as a single session per day and lasted 30 minutes. General physiotherapy session was applied face-to-face for 45 minutes.

06

What researchers measure

Primary outcomes

  1. Spasticity

    Spasticity will assessed using the Modified Ashworth Scale. As the score increases, spasticity increases. The minimum score for this scale is 1 and the maximum score is 5.

    Time frame: Baseline

  2. Stage of hemiplegia

    "Brunnstrom Hemiplegia Recovery Staging" will be used to determine the hemiplegic stage of the patients. This scale is scored between 1 and 6. As the score increases, the patient improves.

    Time frame: Baseline

  3. Motor function

    The "Fugl-Meyer Upper Extremity Motor Assessment Scale" will be used to evaluate upper extremity motor functions. This scale ranges from 0 to 66 points. As the score increases, motor function improves.

    Time frame: Baseline, five week later (after intervention), 3 months later

  4. Dominant side

    The "Edinburgh Hand Preference Test" will be used to determine the dominant side used by the patient in daily life.

    Time frame: Baseline

  5. Trunk Impairment

    "Trunk Impairment Scale" will be used to evaluate trunk impairment in stroke patients. The maximum score that can be obtained from the scale is 23 points. A low score indicates poor performance, a high score indicates good performance

    Time frame: Baseline

  6. Upper extremity function

    Evaluation of upper extremity functions (hand-arm) and motor speed will be done with the "Nine-Hole Peg Test". Function decreases as the time spent for the test increases.

    Time frame: Baseline, five week later (after intervention), 3 months later

  7. Functional Independence

    Evaluation of upper extremity functions will be done with the "Nine-Hole Peg Test". Function decreases as the time spent on the test increases.

    Time frame: Baseline, five week later (after intervention), 3 months later

  8. Cognitif Function

    Mini Mental Test will be used to evaluate cognitive functions. In the evaluation, 24-30 points indicate that cognitive functions are normal, 18-23 points indicate mild cognitive impairment, and 17 points and below indicate that cognitive status is severely affected.

    Time frame: Baseline

  9. Neglect

    The Catherine Bergego Scale will be used to assess the impact of unilateral neglect after stroke on activities of daily living. 1-10 indicates mild neglect, 11-20 indicates moderate neglect, and 21-30 indicates severe neglect.

    Time frame: Baseline

  10. Life Quality

    The Stroke Specific Quality of Life Scale will be used to assess the quality of life of individuals with stroke. The higher the total score, the better the quality of life of the individual with stroke. This scale is scored between 49-245.As the score increases, the quality of life increases.

    Time frame: Baseline, five week later (after intervention), 3 months later

07

Study locations

1 site
  • Mustafa KAVAK
    Karabük, Karabük Province 78100, Turkey (Türkiye)
08

References and documents

Publications

  • Mancuso M, Tondo SD, Costantini E, Damora A, Sale P, Abbruzzese L. Action Observation Therapy for Upper Limb Recovery in Patients with Stroke: A Randomized Controlled Pilot Study. Brain Sci. 2021 Feb 26;11(3):290. doi: 10.3390/brainsci11030290. PubMed 33652680 ↗
  • Shamili A, Hassani Mehraban A, Azad A, Raissi GR, Shati M. Effects of Meaningful Action Observation Therapy on Occupational Performance, Upper Limb Function, and Corticospinal Excitability Poststroke: A Double-Blind Randomized Control Trial. Neural Plast. 2022 Sep 16;2022:5284044. doi: 10.1155/2022/5284044. eCollection 2022. PubMed 36160327 ↗

Related links

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06794749
Lead sponsor
Karabuk University
Responsible party
Mustafa Kavak (Lecturer, MsC, Karabuk University) — Principal investigator
First posted
Jan 27, 2025
Start date
Jan 22, 2025
Primary completion
Jul 25, 2025
Completion
Aug 5, 2025
Last update
Feb 4, 2026

Study contacts

Mustafa KAVAK, MsC
principal investigator · Karabuk University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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