Project summary and aims Project summary and aims

This proof-of-concept trial aimed to examine the effect observation with intent to imitate (OTI) and motor practice (MP) can have on upper limb recovery after stroke.

Early after a stroke, it is important to provide repetitive functional training – a therapy that involves improving strength to help individuals perform the tasks they need to carry out in everyday life.

However, those that have suffered substantial paresis after stroke are unable to take part in repetitive functional training as they do not have enough voluntary muscle control.

What is OTI?

A new therapy, observation-to-imitate (OTI) might help after stroke. Participants watch another person doing something, such as picking up a cup, and then practice doing it as best they can themselves.

The intervention is therefore OTI plus physical practice (OTI+PP). The question we are looking to answer is whether OTI+PP can help people early after stroke when the brain has most capacity for recovery.

What did the trial involve?

All participants received their usual therapy. In addition, those randomly allocated to the treatment group received OTI+PP during three 20-minutes sessions a day for 15 days.

Before and after the intervention period participants undertook some tests of how well they could use their weaker arm and hand. The results will be used to justify a decision on whether or not to begin larger clinical trials.


65 of 570 stroke survivors were eligible, 55 were able to imitate, 37 gave informal consent, 7 were transferred out of area before baseline and 29 were randomised. Outcome measures were completed with 13 CPT participants and 9 OTI+PP participant. No statistically significant differences were found between the two groups.


Cowles T, Clark A, Mares K, Peryer G, Stuck R, Pomeroy V. Observation-to-Imitate plus Practice could add little to physical therapy benefits within 31days of stroke. Translational randomizes controlled trial. Neurorehabilitation and Neural Repair 2013;27(2):1473:182

Key Contact

Professor Valerie Pomeroy
Faculty of Medicine and Health Sciences
University of East Anglia