Improving upper limb motor functions through action observation treatment: a pilot study in children with cerebral palsy

Aim The aim of this randomized controlled trial was to assess whether action observation treatment may improve upper limb motor functions in children with cerebral palsy (CP). Method All children with CP admitted to our unit for rehabilitation from May 2009 to May 2010 were eligible. Inclusion criteria were age between 6 years and 11 years, an IQ of at least 70, and no major visual and/or auditory deficits. Fifteen children were enrolled and randomly assigned to either a case group (n=8; four males, four females; median age 7y 6mo) or control group (n=7; five males, two females; median age 8y). Six participants had left-sided hemiplegia, six right-sided hemiplegia, and three had tetraplegia; 10 were independent walkers. Those in the case group were asked to observe video clips showing daily age-appropriate actions, and afterwards to imitate them. Participants in the control group were asked to observe video clips with no motor content and afterwards to execute the same actions as cases. The primary outcome measure was the Melbourne Assessment Scale. Children were scored twice at baseline (2wks apart), and at the end of treatment, by a physician blind to group assignment. Results At baseline groups did not differ on functional evaluation. After treatment, the functional score gain (?) was significantly different in the case and control groups (p=0.026). Interpretation The present results support the notion that action observation treatment can be an effective part of the rehabilitation programme in children with CP.