Effect of Referent Type on Balance in Action Observation. (ROA)

Effect of Referent Type on Balance in Action Observation in Healthy People: Randomized Clinical Trial.

The objective of the study is to analyze whether observing the actions of a referent selected by the participants improves balance in asymptomatic individuals compared to those who observe a standard referent.

Study Overview

• Status: Completed
• Conditions: Balance Disorders
• Intervention / Treatment: Other: Action observation videos

Detailed Description

Design: Randomized controlled clinical trial. The primary endpoint of the study was the balance recorded by force platform (estatic) and Y balance test (dynamic).

Setting: The participants will be healthy people in the province of Tarragona.

Participants: They will be randomly assigned to one of three groups using a computerized randomized list:

• Control Group (CG): Participants will watch a video of landscapes without human or animal movement.
• Intervention Group with Referent (GIR): Participants will observe actions whose referent has been selected by themselves based on perceived similarity.
• Standard Intervention Group (GIE): Participants will observe actions with a standard reference.

• Study Type: Interventional
• Enrollment (Actual): 165
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Tarragona
    • Reus, Tarragona, Spain, 43203
      • Centre Tecnològic de Nutrició i Salut Eurecat

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Be of legal age.
• Have a mobile device.
• Have normal or corrected-to-normal vision.
• Absence of neurological, orthopedic or vestibular disorders.
• Absence of specific balance skills due to competitive sports.
• Obtain a score of 3 or less on the Tegner activity scale.
• Having voluntarily signed the informed consent and being willing to follow the protocol proposed by the research team.

Exclusion Criteria:

• History of participation in any study with movement representation methods.
• Subjects with impaired communication and/or compression.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control Group; Participants will watch a video of landscapes without human or animal movement.
Experimental: Intervention Group with Referent (GIR); Participants will observe actions whose referent has been selected by themselves based on perceived similarity. A total of 16 different videos will be used, with 4 new videos each week. The videos will gradually increase in difficulty as the study progresses. All exercises are exercises used to improve balance.	Other: Action observation videos; The participant will see videos of balance exercises performed by the assigned reference, depending on their group, without performing any physical movement.
Active Comparator: Standard Intervention Group (GIE); Participants will observe actions with a standard reference. In this case, a basic digitally designed faceless doll will be used. A total of 16 different videos will be used, with 4 new videos each week. The videos will gradually increase in difficulty as the study progresses. All exercises are exercises used to improve balance.	Other: Action observation videos; The participant will see videos of balance exercises performed by the assigned reference, depending on their group, without performing any physical movement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static balance	Center of pressure analysis: The displacement of the center of pressure (CPD) of the participants will be measured through posturographic tests performed on a force platform. The following variables related to the center of pressure (CoP) will be calculated: the roll area (in square millimeters) and the distribution of the weight load on both sides.	1 month
Dynamic Balance	A modified and abbreviated version of the Star Excursion Balance Test, known as mSEBT, will be used. This test has been standardized and validated, and requires a board or floor with three lines indicating directions of movement: anterior (ANT), posteromedial (PM), and posterolateral (PL). These lines form a Y, with an angle of 90° between PM and PL, and 135° between ANT and PM, and ANT and PL.	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Age	Age will be measured in years	1 day
Biological sex	Biological sex will be measured asking if they born like a boy or a girl.	1 day
Weight	Weight will be measured in kg with a Beurer's body analyser scales	1 day
Height	Height will be measured in cm.	1 day
Body mass index (BMI)	Body mass index (BMI) will be measured in kg with a Beurer's body analyser scales	1 day
Length of the lower limb.	Length of the lower limb will be measured in cm.	1 day
Dominant lower limb	Dominant lower limb will be measured asking which limb would shoot a ball with.	1 day
Morphotype	Morphotype (endomorph, ectomorph and mesoform) will be measured by observation	1 day
Trunk and lower extremity muscle strength	Analogue dynamometry will be used as an evaluation method and will be recorded in Newtons (N) with the Saehan SKU SH5007 back, leg and chest dynamometer.	1 month
Satisfaction assessed by a selfcreate questionnaire	A questionnaire specifically designed to evaluate participants' satisfaction with their experience in the study will be used once they have completed their participation.	1 day

Collaborators and Investigators

• Sponsor: University Rovira i Virgili
• Investigators: Study Director: Cristina Adillón Camón, Dra., University Rovira i Virgili

Publications and helpful links

General Publications

• Leem SH, Kim JH, Lee BH. Effects of Otago exercise combined with action observation training on balance and gait in the old people. J Exerc Rehabil. 2019 Dec 31;15(6):848-854. doi: 10.12965/jer.1938720.360. eCollection 2019 Dec.
• Gatti R, Sarasso E, Pelachin M, Agosta F, Filippi M, Tettamanti A. Can action observation modulate balance performance in healthy subjects? Arch Physiother. 2019 Jan 22;9:1. doi: 10.1186/s40945-018-0053-0. eCollection 2019.
• Moon Y, Bae Y. The effect of backward walking observational training on gait parameters and balance in chronic stroke: randomized controlled study. Eur J Phys Rehabil Med. 2022 Feb;58(1):9-15. doi: 10.23736/S1973-9087.21.06869-6. Epub 2021 Sep 1.
• Picot B, Terrier R, Forestier N, Fourchet F, O.McKeon F. The Star Excursion Balance Test: An Update Review and Practical Guidelines. Int. J. Athl. Ther. Train. 2021 Jul 20,26(6):285-93. doi: 10.1123/ijatt.2020-0106.
• Cuenca-Martinez F, Suso-Marti L, Sanchez-Martin D, Soria-Soria C, Serrano-Santos J, Paris-Alemany A, La Touche R, Leon-Hernandez JV. Effects of Motor Imagery and Action Observation on Lumbo-pelvic Motor Control, Trunk Muscles Strength and Level of Perceived Fatigue: A Randomized Controlled Trial. Res Q Exerc Sport. 2020 Mar;91(1):34-46. doi: 10.1080/02701367.2019.1645941. Epub 2019 Oct 18.

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2024
• Primary Completion (Actual): June 30, 2024
• Study Completion (Actual): January 30, 2025

Study Registration Dates

• First Submitted: December 31, 2023
• First Submitted That Met QC Criteria: January 11, 2024
• First Posted (Actual): January 16, 2024

Study Record Updates

• Last Update Posted (Actual): March 9, 2026
• Last Update Submitted That Met QC Criteria: March 5, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Balance; Action observation; Gender; Referent
• Additional Relevant MeSH Terms: Behavior; Sexual Behavior; Coitus
• Other Study ID Numbers: 01/2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No