Action observation therapy effects on motor function and balance in cerebral palsy: an fNIRS-based randomized trial

Cerebral palsy (CP) is an umbrella term for movement, motor, and posture disorders that occur in the developing brain from any non-progressive cause. Action observation therapy (AOT) is a method used in the treatment of motor disorders. Here, the manuscript presents the study protocol for the effect of AOT on balance using functional near-infrared spectroscopy (fNIRS). This study protocol aims to comprehensively evaluate the impact of AOT in patients with CP regarding brain activation and behavioral and motor symptoms. This is a single-center randomized controlled trial for patients with CP. Patients determined eligible according to the study criteria will be randomized into two treatment groups: the action observation therapy group and the control group. Each group will include 12 patients, and the age range is 5-15. The patients will be treated for 15 sessions for three consecutive weeks. In this study, AOT will be applied to improve balance. The following tests will be applied to evaluate the patients' motor function and balance skills before rehabilitation. Gross Motor Function Measure-88 (GMFM-88)-D and E parts, Lower Extremity Selective Control Evaluation Scale (SCALE), The Trunk Impairment Scale (TIS), Pediatric Balance Scale, Nintendo Wii-Fit Balance Score, Timed Up and Go Test (TUG), and Pediatric Data Collection Tool (PODCI) will be applied. Brain regional blood flow changes during static and dynamic balance will be evaluated with fNIRS. All evaluations will be performed before treatment and repeated after treatment.Trial registrations Study was approved by the Istanbul Medipol University Non-Interventional Clinical Research Ethics Committee (Ethical Report No: E-10840098-772.02-3957), registered at ClinicalTrials.gov with the number NCT05995197, 08.09.2023.