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Action observation training reduces freezing of gait among individuals with Parkinson's disease: a systematic review
Iton I, Phillips M, Reardon K, Scarpinella K, Woodcock E, Smith JM
Internet Journal of Allied Health Sciences & Practice 2022 Jan;20(1):6
systematic review

PURPOSE: Recent evidence suggested action observation training (AOT) may benefit individuals with Parkinson's disease (PD) experiencing freezing of gait (FoG). The purpose of this study was to determine if AOT can effectively decrease FoG among people with PD. METHOD: This review followed PRISMA guidelines and was registered a priori with PROSPERO. The databases PubMed, CINAHL, Cochrane Database of Systematic Reviews, PEDro and PROSPERO were searched. Inclusion criteria were randomized controlled studies, an intervention with AOT, adult subjects with PD, published in a journal, and written in English. Study quality was evaluated with the APTA Critical Appraisal Tool for Experimental Intervention Studies (CAT-EI), and level of the evidence with the Oxford Centre for Evidence-based Medicine -- Levels of Evidence for Therapy/Prevention Studies Rating Scale. RESULTS: Five studies met inclusion criteria and yielded 145 participants with a mean age of 69.5 years. Most evidence was rated as acceptable quality, one study rated as low quality, and the level of evidence was high. The studies had participants undergo approximately one hour of intervention, typically two or three times a week for a period of four to eight weeks. Intervention with AOT resulted in significant improvements for the outcome measures of the Timed Up and Go Test (TUG), 10 Meter Walk Test (10MWT), self-reported FoG Questionnaire, self-reported New FoG Questionnaire, and FoG score on the Unified PD Rating Scale. CONCLUSIONS: Based on an acceptable level of evidence, there was a significant effect from the intervention of AOT for decreasing FoG among people with PD. Recommendation is that AOT effectively reduces FoG among people with PD and is a feasible and safe intervention.

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