Introduction: Action simulations, which involve the cognitive rehearsal of motor tasks without overt movement, are considered effective for addressing upper extremity (UE) hemiparesis following stroke. Evidence supports the use of individual action simulation strategies, such as mental practice or action observation, particularly when combined with task-oriented training. Recent research further suggests that combining multiple action simulations within a single treatment session enhances outcomes. Building on this evidence, this study examined the feasibility of combining mental practice and action observation with task-oriented approaches (virtual reality and repetitive task-specific practice) in a circuit training format. This study served as the first proof-of-concept examination of action simulation circuit training (ASCT) for stroke rehabilitation. Preliminary data on the feasibility of ASCT and the potential benefit of ASCT on upper extremity (UE) impairment and quality of life were examined. Methods: Five participants with UE hemiparesis post-stroke completed twelve 60-minute ASCT sessions (2 sessions/week for 6 weeks). Each session included four workstations: mental practice, action observation, virtual reality, and repetitive task-specific practice. Feasibility was assessed using the Acceptability of Intervention Measure, Feasibility of Intervention Measure, and Intervention Appropriateness Measure. Changes in UE impairment and quality of life were examined using the Fugl-Meyer Assessment and the Stroke Impact Scale-Hand subscale, respectively. Results: Participants rated the ASCT group as highly acceptable (M = 19.80, SD = 0.44), feasible (M = 18.40, SD = 1.14), and appropriate (M = 19.40, SD = 1.34). All participants (n = 5) demonstrated reduced UE impairment on the Fugl-Meyer Assessment (M = 3.80, SD = 2.17). Mean change on the Stroke Impact Scale-Hand subscale was minimal (M = 2.50, SD = 8.66), with most participants (n = 4) showing no improvement. Conclusion: Preliminary findings suggest ASCT is a feasible group-based intervention that may improve UE hemiparesis following stroke. ASCT shows promise as a cost-effective option in stroke rehabilitation, warranting further evaluation in larger efficacy trials.
Teresa M. Green (Thu,) studied this question.