Effetti Immediati della AOMI Basata su PETTLEP sulla Cinematica dell'Arto Superiore in Sopravvissuti all'Ictus

Participants will receive a single 13-minute session of a scaffolded AOMI protocol. The session includes a preparation phase involving sensory transfer using the unaffected arm, action observation of a 1st-person video, and selective motor imagery with smoothness and trunk control constraints. No physical execution of the task is performed during the intervention.

A mental practice protocol involving sensory preparation (using the unaffected arm to transfer sensation), action observation, and motor imagery of a reach-to-drink task with selective functional constraints targeting movement smoothness, trunk stability, and shoulder control.

A duration-matched 13-minute session comprising non-motor nature footage (beach, forest, waterfall) paired with scene imagery, followed by paced resonant slow breathing (6 breaths/min) using an expanding/contracting visual circle, containing no upper-limb motor content.

Structured non-motor mental tasks, including attention to breathing and calm mental imagery (e.g., natural scenes or colors), timed to match the experimental intervention and explicitly designed to engage attention without any motor system participation.

Movement smoothness of the affected upper extremity will be quantified as the total Number of Velocity Peaks (NVP) by MediaPipe. Lower NVP values indicate a more continuous movement.

A secondary measure of smoothness calculated using Spectral Arc Length (SPARC) across different phases of the task by MediaPipe. Higher SPARC values indicate smoother movement.

Evaluated as a ratio (0-1) during the reach and reach-to-drink phases. It is calculated by dividing the straight-line distance between the start and end of the wrist path by the total path length travelled. Values closer to 1.0 indicate a straighter, more efficient goal-directed movement path.

Measured in centimeters (cm) as the maximum anterior horizontal shift of the midpoint between the shoulders in the direction of hand travel from lift onset to the highest wrist point, converted using a participant-specific body-based scale factor. Larger values indicate greater compensatory trunk movement.

Measured in centimeters (cm) as the maximum upward vertical displacement of the affected shoulder in the image plane after lift onset (following median smoothing over a 9-frame window). Larger values reflect greater compensatory shoulder hitching during upper-limb movement.

Upper-extremity functional performance will be assessed using the four-item short form of the Wolf Motor Function Test (WMFT-4). Completion time and functional performance scores will be recorded for each item.

Evaluates visual and kinesthetic movement-imagery capacity. The visual and kinesthetic subscale scores are summed separately; each ranges from 5 to 25, and the total score ranges from 10 to 50. Higher scores signify greater vividness of imagery.

Participants indicate their pain intensity by placing a mark on a 10-cm horizontal line. The left side is labeled "no pain" (0) and the right side is labeled "worst pain imaginable".

Evaluates immediate changes in mood state across four dimensions (happy, sad, calm, and tense). Participants rate how they feel at the moment on a 0-10 scale (0 = not at all, 10 = extremely) to control for non-specific emotional responses to the intervention.

A two-item 0-10 self-report scale assessing perceived motor control. Before the intervention, participants rate how well they can control the muscles of the affected arm (0 = no control, 10 = full normal control); immediately after, they rate how much difference they feel in muscle control resulting from the session.