Action Observation Therapy in Children with Congenital Hemiplegia: Systematic Review and Pilot Study.

The aim of this thesis is to discuss a new rehabilitation method based on the discovery of the Mirror Neuron System and on the reorganization of the brain in infants with hemiplegia. Firstly, as our project is based on the use of AOT in rehabilitation we performed a systematic review of the available literature. Many studies both on the upper and lower limb, in adults and people in developmental age have been carried out using this rehabilitation tool. Our systematic review was performed using six different databases and 23 articles that matched the inclusion criteria were identified. We discuss the use of AOT for rehabilitation in stroke patients comparing its use in adults and in people in developmental age, and comparing upper limb and lower limb function. We analysed the different outcome measures used, the length of the training, the type of training performed by the patients and the setting. The review suggests that action observation therapy has a positive effect on the patient’s limb function. Moreover, the review notices the lack of uniformity and the necessity of further well designed, larger controlled trials to determine the optimal type of AOT which elicits a functional improvement of the limb. Then, we conduce a pilot study for a home-based RCT project. We decided to analyse the feasibility and validity of the protocol of a RCT study. We used BBT (Box and Block Test) and AHA (Assisting Hand Assessment) to compare the ICF activity domain before and after the training. Finally these data were compared to those reported in literature