Peer-reviewed article
Action observation therapy in pediatric cerebral palsy: an fNIRS-based investigation of cortical responses and balance-a randomized controlled trial.
Özipek M, Saricaoglu M, Hanoğlu L, Mutluay F ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested Action Observation Therapy (AOT), a motor learning approach based on watching actions, combined with balance training in children with cerebral palsy aged 7-15 years. Children receiving AOT showed similar improvements in balance and movement as children receiving conventional balance training over three weeks. While AOT changed brain activation patterns differently than conventional training, it did not provide additional functional benefits for motor outcomes.
Key points
- Both AOT with action observation videos and conventional balance training improved balance performance, trunk control, and gross motor function significantly (p < 0.05)
- No significant between-group differences in functional motor outcomes were found, meaning AOT provided no additional benefit over conventional training
- AOT produced decreased brain oxygenation levels during balance tasks, while conventional training showed increases or variable responses depending on surface type
- Exercise training and ground surface type (hard versus soft) both significantly influenced brain activation patterns measured by fNIRS
- Study involved 24 children randomly assigned to AOT (n=12) or control group (n=12) with 30-minute daily sessions for three weeks
Limitations
The study does not report whether findings apply to different age groups, severity levels of cerebral palsy, or whether effects persist beyond the three-week intervention period. The small sample size and short duration may limit generalizability to broader populations of children with CP.
Abstract
Background Cerebral palsy (CP) is a group of permanent neurodevelopmental disorders affecting movement and posture, often accompanied by sensory, perceptual, and cognitive impairments. Action Observation Therapy (AOT), based on mirror neuron activation, has emerged as a promising approach for motor learning and rehabilitation. This study aimed to evaluate the effects of AOT on brain activation and motor-behavioral outcomes in children with CP. Methods Participants aged 7-15 years who met the inclusion criteria were randomly assigned to either the AOT Group (n = 12) or the Control Group (n = 12). The AOT Group received balance training combined with action observation videos, whereas the Control Group received conventional balance training with non-motor videos and written instructions. Both groups participated in the same exercise program for 30 min per day, five days per week, for three weeks, with progressively increasing difficulty. Pre- and post-treatment assessments included the Pediatric Balance Scale as the primary outcome measure, along with secondary outcomes of functional mobility (Timed Up and Go Test), trunk control (Trunk Impairment Scale), and gross motor function (Gross Motor Function Measure-88 sections D and E). Cortical hemodynamic responses during balance tasks on hard and soft surfaces were assessed using functional Near Infrared Spectroscopy (fNIRS) as the mechanistic outcome measure. Results Both groups showed significant improvements in balance performance, TUG scores, trunk control, and gross motor function after treatment (p < 0.05), with no significant between-group differences (p > 0.05). Exercise training and ground type significantly influenced cerebral oxygenation, with variations in oxyhemoglobin concentrations across brain regions depending on time, group, and video observation interactions (p < 0.05). Oxyhemoglobin levels decreased in the AOT Group, whereas the Control Group showed increases or surface-dependent fluctuations (p < 0.05). Conclusions Both AOT and conventional motor learning-based balance training improved balance and motor function in children with CP. However, AOT did not provide additional functional benefits. Exercise training and ground type significantly influenced cerebral oxygenation. Decreased oxyhemoglobin levels in the AOT Group and variable responses in the Control Group suggest modulation of cortical activation by sensorimotor context. Trial registration ClinicalTrials.gov (NCT05995197).
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
Problem
Children with cerebral palsy have impaired balance, motor function, and cortical motor processing
- Intervention
- Action Observation Therapy (AOT) combining balance training with action observation videos showing motor tasks
- Population
- Children aged 7-15 years with cerebral palsy (n=24, split into AOT n=12 and control n=12)
Key finding
Both groups showed significant improvements in balance, trunk control, and gross motor function (p < 0.05)
M et al. · Europe PMC · 21 Jul 2026