Influence of referent selection on balance in action observation: A randomized controlled trial

Action observation (AO) generates motor simulations in the brain, activating areas involved in actual movement and facilitating imitation. This randomized controlled trial aimed to analyze if observing actions performed by a personally selected referent improves balance in asymptomatic individuals compared to observing a standard referent.

A total of 165 healthy participants were randomized into three groups: a control group observing landscape videos, a standard referent group observing an unidentifiable model, and a chosen referent group selecting models based on personal similarity. Balance (static and dynamic) and strength were assessed at baseline, immediately post-intervention, at 15 days, and at 4 weeks. AO exercises related to balance were viewed three times per week for four weeks.

Key findings revealed favorable changes in static balance for both the standard and chosen referent groups, particularly in challenging single-leg stances with eyes closed. Strength improvements were observed only in the standard referent group. Average adherence to the protocol was 91%.

AO enhances balance and strength in healthy individuals, with referent characteristics significantly impacting outcomes. The findings suggest referent selection is a crucial factor in AO's efficacy, emphasizing AO's therapeutic potential, particularly for populations with mobility challenges. Further research should refine referent selection to optimize clinical results.