Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis

ABSTRACT Introduction: Action Observation Therapy (AOT) is a rehabilitation method believed to activate the mirror neuron system, which may contribute to cognitive recovery. Previous studies have shown varying results due to different intervention characteristics. This review will examine the effica...

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Main Authors: Xuewei Guan, Meijuan Lan, Leiwen Tang, Hongyan Yang, Yuanyuan Chen, Lan Ge, Yumei Zhong
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Brain and Behavior
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Online Access:https://doi.org/10.1002/brb3.70474
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author Xuewei Guan
Meijuan Lan
Leiwen Tang
Hongyan Yang
Yuanyuan Chen
Lan Ge
Yumei Zhong
author_facet Xuewei Guan
Meijuan Lan
Leiwen Tang
Hongyan Yang
Yuanyuan Chen
Lan Ge
Yumei Zhong
author_sort Xuewei Guan
collection DOAJ
description ABSTRACT Introduction: Action Observation Therapy (AOT) is a rehabilitation method believed to activate the mirror neuron system, which may contribute to cognitive recovery. Previous studies have shown varying results due to different intervention characteristics. This review will examine the efficacy of AOT on clinical cognitive function in stroke. Methods: Randomized controlled trials (RCTs) comparing AOT with non‐AOT interventions in cognitive function were included. Databases searched included PubMed, Cochrane Library, Embase, Web of Science, EBSCO, CNKI, WanFang, and VIP database from inception to May 6, 2024. The risk of bias was assessed using Cochrane's Risk of Bias Assessment Tool 2.0, and the quality of evidence was evaluated with the GRADE approach. RevMan 5.4 and Stata 18.0 were used for the meta‐analysis. After the analysis of cognitive function, meta‐regression was performed to explore the possible sources of heterogeneity. A random‐effects meta‐analysis model using the inverse‐variance and Hartung–Knapp methods was used to calculate pooled estimates and 95% confidence interval (CI) values. We examined the funnel plot and used Egger's regression test to assess for publication bias. This study was conducted by PRISMA reporting guidelines (Appendix S1). The search protocol was prospectively registered in PROSPERO (CRD42024571694). Results: A total of 6 RCTs with 400 participants were included. All the included articles were rated as having B‐level quality. Meta‐analysis showed that AOT significantly improved cognitive function in stroke. Meta‐regression did not find the source of heterogeneity. The GRADE result indicated that the finding was of very low certainty. Conclusions: Cognitive interventions based on AOT can improve cognitive function in stroke patients. However, it should be interpreted cautiously due to heterogeneity and low certainty. To strengthen evidence‐based practices, we advocate for higher‐quality and more homogeneous RCTs, including strict randomization procedures, large sample sizes, extended follow‐up periods, and studies focused on specific disease subtypes.
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spelling doaj-art-261fba46f5f14a1e900c04d19b23e60e2025-08-20T03:53:41ZengWileyBrain and Behavior2162-32792025-04-01154n/an/a10.1002/brb3.70474Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐AnalysisXuewei Guan0Meijuan Lan1Leiwen Tang2Hongyan Yang3Yuanyuan Chen4Lan Ge5Yumei Zhong6Nursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaNursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaNursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaNursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaNursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaNursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaNursing DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou ChinaABSTRACT Introduction: Action Observation Therapy (AOT) is a rehabilitation method believed to activate the mirror neuron system, which may contribute to cognitive recovery. Previous studies have shown varying results due to different intervention characteristics. This review will examine the efficacy of AOT on clinical cognitive function in stroke. Methods: Randomized controlled trials (RCTs) comparing AOT with non‐AOT interventions in cognitive function were included. Databases searched included PubMed, Cochrane Library, Embase, Web of Science, EBSCO, CNKI, WanFang, and VIP database from inception to May 6, 2024. The risk of bias was assessed using Cochrane's Risk of Bias Assessment Tool 2.0, and the quality of evidence was evaluated with the GRADE approach. RevMan 5.4 and Stata 18.0 were used for the meta‐analysis. After the analysis of cognitive function, meta‐regression was performed to explore the possible sources of heterogeneity. A random‐effects meta‐analysis model using the inverse‐variance and Hartung–Knapp methods was used to calculate pooled estimates and 95% confidence interval (CI) values. We examined the funnel plot and used Egger's regression test to assess for publication bias. This study was conducted by PRISMA reporting guidelines (Appendix S1). The search protocol was prospectively registered in PROSPERO (CRD42024571694). Results: A total of 6 RCTs with 400 participants were included. All the included articles were rated as having B‐level quality. Meta‐analysis showed that AOT significantly improved cognitive function in stroke. Meta‐regression did not find the source of heterogeneity. The GRADE result indicated that the finding was of very low certainty. Conclusions: Cognitive interventions based on AOT can improve cognitive function in stroke patients. However, it should be interpreted cautiously due to heterogeneity and low certainty. To strengthen evidence‐based practices, we advocate for higher‐quality and more homogeneous RCTs, including strict randomization procedures, large sample sizes, extended follow‐up periods, and studies focused on specific disease subtypes.https://doi.org/10.1002/brb3.70474Action Observation Therapycognitive functionmeta‐analysisstroke
spellingShingle Xuewei Guan
Meijuan Lan
Leiwen Tang
Hongyan Yang
Yuanyuan Chen
Lan Ge
Yumei Zhong
Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis
Brain and Behavior
Action Observation Therapy
cognitive function
meta‐analysis
stroke
title Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis
title_full Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis
title_fullStr Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis
title_full_unstemmed Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis
title_short Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta‐Analysis
title_sort efficacy of action observation therapy on cognitive function in stroke a systematic review and meta analysis
topic Action Observation Therapy
cognitive function
meta‐analysis
stroke
url https://doi.org/10.1002/brb3.70474
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