1Assistant Professor in Physiotherapy, College of Physiotherapy, Mother Theresa Post Graduate and Research Institute of Health Sciences, A Govt. of Puducherry Institution, Affiliated to Pondicherry University, Indira Nagar, Gorimedu, Puducherry -605 006.
2Senior Specialist Physical Therapist, Mind Optimization & Health Advancement Network, 139, VOC Street, Thirukuralar Nagar Arumparthapuram Reddiyarpalayam Post Pondicherry 605010
3Assistant Professor, University Institute of Allied Health Sciences, Chandigarh University, Gharuan Mohali Punjab 140413
4Assistant Professor, Department of Physiotherapy, SOAHS, Noida International University, Plot 1, Yamuna Expy, Sector 17A, Uttar Pradesh 203201
5Assistant Professor, Apollo college of Physiotherapy, Anjora Durg, Chhattisgarh, Pt Deendayal Upadhyay Memorial Health Science & Ayush University of Chhattisgarh, Raipur, pin code 493661
6Principal cum Professor, Dhaneshwari College of Physiotherapy, Gevrai Tanda, Pathan Road, Chhatrapati Sambhaji Nagar -431001
7Senior Physical Therapist, Mind Optimization & Health Advancement Network, 139, VOC Street, Thirukuralar Nagar Arumparthapuram Reddiyarpalayam Post Pondicherry 605010
8Sports Physiotherapist, Rashtriya Raksha University. Lavad, Ta. Dehgam, Gandhinagar. Gujarat, India - 382305
Background: Stroke often results in upper limb motor deficits that impair daily function. Cognitive motor strategies such as Action Observation (AO) and Motor Imagery (MI) have been shown to enhance motor recovery by activating motor cortical networks. This study investigated the comparative and combined effects of AO and MI integrated with conventional therapy on upper limb function and functional independence in stroke survivors.
Methods: A randomized controlled trial was conducted with 60 stroke patients, allocated into three groups (n = 20 each): Group A received AO + conventional therapy, Group B received MI + conventional therapy and Group C received combined AO + MI + conventional therapy. Interventions were delivered 5 days/week for 6 weeks. Outcome measures included Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT) and Functional Independence Measure (FIM). Data were analyzed using paired t-tests for within-group changes and one-way ANOVA for between-group comparisons (p < 0.05).
Results: All groups showed significant improvements in FMA-UE, ARAT, and FIM scores post-intervention (p<0.001). Post-test comparisons revealed the combined AO + MI group (Group C) had the highest improvements: FMA-UE 46.8 ± 5.1, ARAT 49.6 ± 6.0 and FIM 94.1 ± 7.5, followed by MI alone (Group B) and AO alone (Group A). Between-group differences were statistically significant for all outcomes (FMA-UE F = 17.54, ARAT F = 19.21, FIM F = 13.68; p < 0.001).
Conclusion: Cognitive motor interventions significantly enhance upper limb motor recovery and functional independence in stroke patients. The combined AO + MI approach yielded superior outcomes compared to AO or MI alone, suggesting that integrating observation and mental rehearsal into conventional therapy maximizes neuroplasticity and functional restoration.
Keywords: Stroke, Action Observation, Motor Imagery, Upper Limb Rehabilitation, Fugl-Meyer Assessment, Action Research Arm Test, Functional Independence Measure.
How to cite this article: B S, Nallathambi M, Kuriyal S, Banga N, Sahu S, Sharma A, Mou I, Ghosh S, “Training The Brain Before The Body: Motor Imagery And Action Observation In Stroke Recovery”..Int J Drug Deliv Technol. 2026;16 (13s): 62-67; DOI: 10.25258/ijddt.16.13s.7
Source of support: None
Conflict of interest: None