A new study testing the effect of a home-based action observation treatment for arm rehabilitation in multiple sclerosis patients (MS) is now open. 

The aims of the study are to compare the effects of a home-based virtual reality action observation treatment to a virtual reality landscape observation on the motor performance of the arms, to measure any functional changes in the brain following either approach and explore the correlation between these changes and any clinical improvements.

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The randomized, controlled, single-blinded, parallel study aims to recruit 60 patients with the disease. Patients were 18 to 65 years of age. Half of these patients will be randomly assigned to a home-based action observation treatment, while the other half will be assigned to a home-based landscape observation. 

Those in the first group will watch 2 different videos showing several repetitions of a certain motor task of typical activities of daily living using the arms. They will then imagine and perform the same actions using provided objects. Each session will last 30 minutes and will take place 5 times a week on 3 consecutive weeks with different actions that become progressively more difficult.

Those in the second group, on the other hand, will first observe virtual landscapes, rest with their eyes closed, and then perform the same actions as those performed by the patient in the first group. Sessions will last the same amount of time as in the first group. 

The primary outcome measure will be any changes in the right-hand nine-hole peg test (9HPT), a measure of hand dexterity. 

Secondary outcome measures will include any change in left-hand 9HPT, hand grip strength, finger tapping frequency, segmental arm strength, arm spasticity, Expanded Disability Status Scale (EDSS), quality of life measures, brain volume, and brain activation during an object manipulation task.

The trial will take place in Milan, Italy but is not yet recruiting participants. It is estimated to start in March 2023 and be completed in July 2025. 

Action observation treatment is a rehabilitative approach proposed to improve motor performance in patients with neurological conditions, including MS.


Home-based action observation treatment with virtual-reality for arm rehabilitation in people with multiple sclerosis. US National Library of Medicine. Updated February 6, 2023. Accessed February 6, 2023.