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First-Person Perspective Action Observation Training in Individuals With Parkinson's Disease: A Consideration-of-Concept Controlled Pilot Trial

Background and Purpose: Action observation training (AOT) consists of the observing of actions performed by others, followed by imitation. Physical therapy techniques based on action observation may influence motor performance in individuals with idiopathic Parkinson's disease (IPD). Objectives: The aim of this pilot study was to provide a preliminary approach to assess AOT in anatomical first-person perspective (FPP) as a rehabilitation technique to improve body function and activity in individuals with disability due to IPD. Methods: Videos showing in FPP movements of the upper and lower limbs were produced. A research protocol was designed and tested for feasibility. After baseline assessment, 16 participants with mild to moderate disability due to IPD, all receiving conventional physical therapy group treatment, were nonrandomly assigned to either 1 extra hour of individualized FPP AOT per session or comparison group. Upper and lower limb functioning, independence in activity of daily living, and mobility were assessed before and after training. Data were analyzed by descriptive statistics; statistical comparisons were conducted as part of the feasibility assessment of the data management plan by means of nonparametric tests. Results: A set of 22 videos was created and administered. Groups were comparable at baseline assessment. All participants completed the study and had complete data. Compared with baseline, both groups improved significantly. The experimental group had a better response based on change scores, and the differences were large for 3 of the outcome measures. No significant between-group differences were observed. Discussion: The equipment needed for the production of the videos was easily available. The study protocol was successfully implemented. Adherence rates to study procedures were excellent, and no adverse events occurred. Differences in methods and participant populations prevented comparison in our experimental approach. The number and content of videos, and the length of the sessions proposed, was close to that of other studies providing an FPP AOT program in individuals with cerebral palsy and stroke. Both groups improved and the effect was greater for the experimental one. However, no significant difference between the groups was observed. Conclusions: This pilot study suggests that FPP AOT is a feasible intervention and the research protocol designed would be suitable, with minor modifications, for the conduction of a subsequent stage 2 trial designed to verify the hypothesis that the adjunct of FPP AOT might improve motor performance in individuals with IPD.