Effects of Action Observation and Mirror Therapy on Upper Extremity Functions in Unilateral Cerebral Palsy: A Randomized Controlled Trial.

AIM: To examine the effects of Action Observation Therapy (AOT) and Mirror Therapy (MT) on occupational performance, occupational satisfaction, goal-oriented activities, bilateral hand skills, and upper extremity functions in children with unilateral cerebral palsy (CP).

METHOD: This randomized controlled trial included 24 children with unilateral CP (12 AOT, 12 MT) aged 6-12 years. Both groups received 18 sessions over 6 wk (3 days/week), consisting of 30 min of Bilateral Activity Training (BAT) combined with 30 min of AOT or MT. Outcomes were assessed using the Canadian Occupational Performance Measure, Goal Attainment Scale, Shriners Hospital Upper Extremity Evaluation, and ABILHAND questionnaire at baseline, post-intervention, and 1-month follow-up.

RESULTS

Both groups showed significant improvements in occupational performance, satisfaction, goal attainment, bilateral hand skills, and upper extremity function after treatment (all p < 0.001) and at follow-up (AOT: p = 0.02-0.09; MT: p = 0.02-0.05). Although some variation in effect size estimates was observed across outcomes, between-group differences were not statistically significant (all p > 0.05).

INTERPRETATION: AOT and MT, when combined with BAT, appear to be effective complementary interventions for improving upper extremity-related outcomes in children with unilateral CP.

TRIAL REGISTRATION: This study was registered as a Clinical Trial Number with the code NCT05951829.