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ObjectiveTo systematically evaluate the effect of action observation therapy (AOT) on upper limb function in children with cerebral palsy. MethodsRelevant literatures about the effect of AOT on upper limb function in children with cerebral palsy were retrieved from the databases of PubMed, Embase, Cochrane Library, Web of Science and CNKI, from the establishment to July 9, 2022. ResultsEleven articles involving 497 patients were included, which were mainly published in the past ten years. The studies included hospital-based studies with therapist supervision and home-based studies without therapist supervision, mainly related to the improvement of upper limb function of AOT in children with cerebral palsy. Experimental group performed actions related to activities of daily living, while control group mainly watched video clips excluding actions, 15 to 120 minutes a time, three to five times a week, with most of the intervention periods of three to four weeks. AOT improved the upper limb function of children with cerebral palsy in terms of body structure and function, and activity and participation, specifically grip strength, muscle tension, and hand dexterity and function. ConclusionHospital-based AOT with therapist supervision can improve upper limb function in children with cerebral palsy, while the effect of home-based AOT without therapist supervision and the long-term effect of AOT need to be further studied.
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ObjectiveTo investigate the effect of mirror therapy with augmented reality on attention of stroke patients. MethodsFrom January, 2020 to December, 2022, 60 stroke patients in the First People's Hospital of Changzhou were randomly divided into control group (n = 30) and observation group (n = 30). Both groups received routine occupational therapy, and the observation group received mirror therapy with augmented reality additionally, for four weeks. They were assessed with Digit Span Test (DST), Digit Cancellation Test (D-CAT3 and D-CAT3P), Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) before and after treatment. ResultsBefore treatment, there was no significant difference in the scores of the DST, D-CAT3, D-CAT3P, SDMT and PASAT between two groups (P > 0.05). After treatment, all the indexes improved in the observation group (|t| > 3.663, P < 0.01), and improved more in the observation group than in the control group (|t| > 2.037, P < 0.05). ConclusionThe mirror therapy with augmented reality could effectively improve attention of stroke patients in the short term.
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Objective:To observe the effect of oral-facial muscle training applying virtual reality technology (VR) and of action observation therapy on the salivation of children with cerebral palsy (CP).Methods:Sixty CP children with uncontrolled salivation were randomly divided into a control group and an observation group, each of 30. In addition to conventional rehabilitation treatment, the control group received routine tongue muscle training, buccal lip muscle training, ice stimulation, and Masako swallowing training. The observation group received oral-facial muscle training based on action observation therapy in a virtual environment. Both groups were trained 30min per day, 5 times a week for 3 weeks. Before and after the treatment, drooling (DDSS) and swallowing function scores were evaluated. Integrated surface electromyography (iEMG) of the buccinator and orbicularis oris muscles was also performed.Results:After treatment, a significant decrease was observed in the average DDSS and the swallowing function scores of both the control and observation groups, along with a significant increase in the average root mean square values of the buccinator and orbicularis oris iEMGs of both groups. However, the average DDSS score of the observation group was significantly lower than that of the control group, while the average iEMG readings were significantly better.Conclusion:VR-based action observation oral-facial muscle training is a more effective supplement to conventional rehabilitation treatment than conventional oral-facial muscle training in improving the salivation of children with CP.
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Objective:To observe any effect of combining repetitive transcranial magnetic stimulation (rTMS) under the guidance of event related potentials (ERPs) with action observation therapy (AOT) on the cognitive and motor functioning of stroke survivors in the recovery period.Methods:Ninety stroke survivors were randomly divided into a control group, an rTMS group and an rTMS+ AOT group, each of 30. All three groups were given conventional rehabilitation treatment (including the training of waist, upper and lower limb function, balance, walking, memory, attention, orientation, spatial perception and executive ability). The rTMS group also received one session of ERP-based rTMS daily five times a week. The rTMS+ AOT group was given the same rTMS combined with AOT twice a day, five times a week. Before and after 4 weeks of treatment, the Mini-mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MOCA), the Fugl-Meyer assessment scale (FMA), the Berg Balance Scale (BBS) and the modified Barthel index (MBI) were used to evaluate each subject′s cognitive and motor ability and their skill in the activities of daily living.Results:After the treatment, the average MMSE, MOCA, FMA, BBS and MBI scores of all groups had improved significantly, but the average MMSE, MOCA, upper limb FMA and MBI scores of the rTMS group were then significantly higher than the control group′s averages. And the average scores of the rTMS+ AOT group were significantly better than those of the other two groups.Conclusion:Combining rTMS guided by ERPs with AOT can effectively improve the cognitive functioning, motor control and balance of stroke survivors, and improve their ability in the activities of daily living.
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Abstract Aim: Learning by action observation (AO) is a fundamental cognitive ability existing from birth either in live or in the video. However, the specific AO training, in live or in the video, can influence decision making and motor planning in healthy children? This study aimed to evaluate if a single session of both practices (live and video) modifies the choice reaction time during reaching tasks in healthy children. Methods: This is a cross-sectional and randomized study with 22 children aged 6 to 8 years. We measured the choice reaction time (CRT) by electromyography at baseline and after both practices. Data were analyzed using Friedman and posthoc Dunn non-parametric tests for each age group individually as well as all ages combined. Kurtosis analysis was performed to assess data variability. Results: Significant decrease in CRT was observed after action observation in the video in 8-year-olds. Also, we observed choice reaction time variability reduction in 8-year-olds after both practices compared to that at baseline. Conclusion: A decrease in CRT was observed after the single session of action observation in the video in 8-year-olds. Additionally, there was a reduced variability in CRT after performing both practices in the same age group.
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Humans , Child , Cognition , Observation/methods , Learning , Reaction Time , Cross-Sectional StudiesABSTRACT
Abstract. Owing to advancement of medical technology and current knowledge, the population has a longer life expectancy, leading to an increase in the proportion of elderly. Objective: The study aimed to investigate the effect of action observation (AO) combined with gait training on gait and cognition in elderly with mild cognitive impairment (MCI). Methods: Thirty-three participants were randomly allocated to action observation with gait training (AOGT), gait training (GT), and control (CT) groups. The AOGT and GT groups received a program of observation and gait training protocol with the same total duration of 65 min for 12 sessions. For the observation, the AGOT group watched a video of normal gait movement, while the GT group watched an abstract picture and the CT group received no training program. All participants were assessed for gait parameters during single- and dual-tasks using an electronic gait mat system and were assessed for cognitive level using the Montreal Cognitive Assessment (MoCA) at baseline, after training and at 1-month follow-up. Results: The results showed that the AOGT group had significant improvements in gait speeds during single- and dual-tasks, as well as better MoCA score, while the GT group had significant improvement only in gait speed. Conclusion: The adjunct treatment of AO with gait training provides greater benefits for both gait and cognitive performances in elderly with MCI.
Resumo. Com o avanço da tecnologia médica e do conhecimento atual, a população tem uma expectativa de vida mais longa, levando a um aumento na proporção de idosos. Objetivo: O estudo teve como objetivo investigar o efeito da observação de ação (AO) combinada com o treinamento da marcha na marcha e cognição em idosos com comprometimento cognitivo leve (CCL). Métodos: Trinta e três participantes foram alocados aleatoriamente para observação de ação com grupos de treinamento de marcha (AOGT), treinamento de marcha (GT) e controle (CT). Os grupos AOGT e GT receberam um programa de observação e protocolo de treinamento de marcha com a mesma duração total de 65 minutos por 12 sessões. Na observação, o grupo AGOT assistiu a um vídeo de movimento normal da marcha, enquanto o grupo GT assistiu a uma figura abstrata e o grupo CT não recebeu nenhum programa de treinamento. Todos os participantes foram avaliados quanto aos parâmetros da marcha durante tarefas simples e duplas, utilizando um sistema eletrônico de esteira da marcha e avaliados quanto ao nível cognitivo, utilizando a Avaliação Cognitiva de Montreal (MoCA) na linha de base, após o treinamento e 1 mês de acompanhamento. Resultados: Os resultados mostraram que o grupo AOGT apresentou melhorias significativas nas velocidades da marcha durante tarefas simples e duplas, além do escore MoCA, enquanto o grupo GT teve melhora significativa apenas na velocidade da marcha. Conclusão: O tratamento adjunto da AO com o treinamento da marcha proporciona maiores benefícios tanto do desempenho da marcha quanto do desempenho cognitivo em idosos com CCL.
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Humans , Gait , Signs and Symptoms , Cognition , Cognitive DysfunctionABSTRACT
Objective:To compare the effects of observation to non-goal-oriented hand actions with video or pictures on speech recovery in stroke patients with chronic non-fluent aphasia. Methods:From January, 2016 to December, 2018, 30 patients with non-fluent aphasia after stroke were randomly divided into two groups. The control group (n = 15) repeated the verbs after watching picture, and the experimental group (n = 15) repeated the verbs after watching videos, for four weeks. They were assessed with Western Aphasia Battery (WAB) before treatment and every week after treatment. Results:Aphasia quotient (AQ) increased with time (F > 32.922, P < 0.001), but no significant difference was found between two groups at any time points (t < 0.699, P > 0.05). The interactive effect between time and group was significant (F = 6.398, P < 0.001), which suggested that AQ increased more in the experimental group than in the control group. Conclusion:For non-goal-oriented hand action observation, video observation maybe promote speech recovery in stroke patients with chronic non-fluent aphasia.
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Objective:To explore the effects of action observation therapy on upper limb severe hemiplegia. Methods:From January to June, 2019, 40 patients with severe hemiplegia after stroke were randomly divided into control group (n = 20) and observation group (n = 20). Before routine rehabilitation training, the observation group watched the videos about activities and movements of arms and hands, and then were asked to imagine their affected arms and hands to complete these movements. The control group watched the videos of orderly geometric figures, letters and others without body and animals. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Motor Assessment Scale-Upper Extremities (MAS-UE) and modified Barthel Index (MBI) before and four weeks after treatment. Results:The scores of FMA-UE, MAS-UE and MBI improved after treatment (t > 2.854, P < 0.05), and improved more in the observation group than in the control group (F > 4.395, P < 0.05). Conclusion:action observation therapy can further improve upper limb motor function and activities of daily living in patients with severe hemiplegia after stroke.
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Objective@#To observe the effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living after a stroke.@*Methods@#Forty-two stroke survivors were randomly divided into a treatment group and a control group, each of 21. Both groups were given conventional rehabilitation training and conventional occupational therapy. The treatment group additionally performed action observation. The Fugl-Meyer assessment (FMA-UE), a Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) and the Modified Barthel index (MBI) were used for assessment before and after 8 weeks of treatment.@*Results@#Before the treatment there were no significant differences between the two groups. Afterward, significant improvement was observed in all of the measurements in both groups. Compared with the control group, the treatment group showed more significant improvement in its average FMA-UE, FTHUE-HK and MBI scores.@*Conclusion@#Action observation can improve the effects of rehabilitation and occupational therapy after stroke.
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Objective To observe the effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living after a stroke. Methods Forty-two stroke survivors were randomly divided into a treatment group and a control group, each of 21. Both groups were given conventional rehabilita-tion training and conventional occupational therapy. The treatment group additionally performed action observation. The Fugl-Meyer assessment ( FMA-UE ) , a Hong Kong version of the functional test for the hemiplegic upper extremity ( FTHUE-HK) and the Modified Barthel index ( MBI) were used for assessment before and after 8 weeks of treatment. Results Before the treatment there were no significant differences between the two groups. Afterward, significant im-provement was observed in all of the measurements in both groups. Compared with the control group, the treatment group showed more significant improvement in its average FMA-UE, FTHUE-HK and MBI scores. Conclusion Action observation can improve the effects of rehabilitation and occupational therapy after stroke.
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PURPOSE: We compared the activation pattern of the mirror neurons (MN) between two types of hand movement according to action observation using functional MRI. METHODS: Twelve right-handed healthy subjects (5 male and 7 female, mean age 21.92±2.02 years) participated in the experiment. During fMRI scanning, subjects underwent two different stimuli on the screen: 1) video clips showing repeated grasping and releasing of the ball via simple hand movement (SHM), and (2) video clips showing an actor performing a Purdue Pegboard test via complex hand movement (CHM). paired t-test in statistical parametric mapping (SPM) was used to compare the activation differences between the two types of hand movement. RESULTS: CHM as compared with the SHM produced a higher blood oxygen level dependent (BOLD) signal response in the right superior frontal gyrus, left inferior and superior parietal lobules, and lingual gyrus. However, no greater BOLD signal response was found by SHM compared with CHM (FWE corrected, p<0.05). CONCLUSION: Our findings provided that the activation patterns for observation of SHM and CHM are different. CHM also elicited boarder or stronger activations in the brain, including inferior parietal lobule called the MN region.
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Female , Humans , Male , Brain , Hand Strength , Hand , Healthy Volunteers , Magnetic Resonance Imaging , Mirror Neurons , Occipital Lobe , Oxygen , Parietal Lobe , Prefrontal CortexABSTRACT
Objective:To explore the effects of action observation training based on mirror neuron system on motor function of upper extremities in stroke patients. Methods:From June, 2016 to June, 2017, 61 stroke patients were randomly assigned to control group (n = 30) and observation group (n = 31). They all accepted routine rehabilitation, and the observation group received action observation therapy in addition, for eight weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities, modified Ashworth Scale and modified Barthel Index before and after treatment. Results:All the indexes improved in both groups after treatment (|t| > 2.651, P < 0.05), and improved more in the observation group than in the control group (|t| > 2.048, P < 0.05). Conclusion:The action observation training may further improve the upper extremity motor function in stroke patients.
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@#Objective To explore the effect of action observation therapy on unilateral spatial neglect after stroke.Methods From March, 2017 to April, 2018, 44 patients with left-sided neglect due to unilateral right-sided vascular brain lesions were randomly divided into control group (n=22) and experimental group (n=22). The control group received the dynamic landscape video observation training, and the experimental group received the action observation training, based on routine rehabilitation, for three weeks. Before treatment, one week and three weeks after treatment, they were evaluated with Chinese Behavioral Inattention Test-Hong Kong version (CBIT-HK) routine tests (short line cancellation test, letter cancellation test, star cancellation test and line segment bisect), and the scores of Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA) and Activities of Daily Living (ADL) were compared.Results One week after treatment, four scores of CBIT routine tests almost improved (t>2.712, P<0.05), and the score of line segment bisect was significantly better in the experiment group than in the control group (t=4.822, P<0.001). Three weeks after treatment, four scores of CBIT routine tests and the scores of MMSE, FMA and ADL improved in both groups (t>1.596, P<0.05), and the scores of short line cancellation test, letter cancellation test and line segment bisect were significantly lower in the experiment group than in the control group (t>3.577, P<0.01).Conclusion The action observation therapy could faciliate to improve the lateral neglect of patients after stroke.
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We present a 47-year-old right-handed woman with a 15-year history of writer's cramp who was provided with six sessions of cathodal transcranial direct current stimulation (tDCS) combined with observation of writing actions performed by a healthy subject and electromyographic (EMG) biofeedback training to decrease EMG activities in her right forehand muscles while writing for 30 min for 4 weeks. She showed improvement in dystonic posture and writing speed after the intervention. The writing movement and writing speed scores on a writer's cramp rating scale decreased, along with writing time. Our findings demonstrated that cathodal tDCS combined with action observation and EMG biofeedback training might improve dystonic writing movements in a patient with writer's cramp.
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Female , Humans , Middle Aged , Biofeedback, Psychology , Dystonic Disorders , Healthy Volunteers , Muscles , Posture , Transcranial Direct Current Stimulation , WritingABSTRACT
@#Objective To explore the effect of action observation therapy (AOT) on upper limb function in children with spastic hemiplegic cerebral palsy,and the better program. Methods From March to November,2017,45 children with spastic hemiplegic cerebral palsy were randomly assigned to control group and AOT group.The control group was further divided into group A(n=11)and group B(n=11), and received conventional rehabilitation treatment and scenic-observation therapy, 20 minutes every time for group A,and 30 minutes every time for group B.AOT group was further divided into group C(n=10)and group D (n=11), and received AOT in addition, 20 minutes every time for group C, and 30 minutes every time for group D,five times each week for twelve weeks for all the groups.Before treatment,eight and twelve weeks af-ter treatment, they were assessed with hand grip strength, Upper Extremities Functions Test (UEFT), and Wee Functional Independence Measure(WeeFIM). Results After treatment,the hand grip strength and the score of UEFT were better in group D than in groups B and C(P<0.05),and were better at twelve weeks than at eight weeks(P<0.05).No significant difference was found in the score of WeeFIM among groups after treatment(P>0.05). Conclusion AOT could improve upper limp function in children with spastic hemiplegic cerebral palsy,and it's more ef-fective after more training.
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Objective To explore the effects of action observation therapy on upper-extremity motor function and ability in the activities of daily living after cerebral infarction.Methods Forty-one cerebral infarction survivors were randomly assigned to an observation group (n =21) or a control group (n =20).Both groups were given the conventional rehabilitation treatment,while the observation group additionally received action observation therapy 20 mins per day,6 times per week for 8 weeks.Before and after the 8 weeks of treatment,both groups were assessed using the Fugl-Meyer assessment (FMA),Wolf's motor function test (WMFT) and the modified Barthel index (MBI).Results Before the intervention there was no significant difference between the groups in any of the measurements.After the 8 weeks of treatment,all of the results in the treatment group were significantly better,on average,than those of the control group.Conclusions Action observation therapy can improve upper-extremity motor function and ability in the activities of daily living after stroke.
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Objective To explore the effects of action observation therapy on upper-extremity motor function after ischemic stroke and on the motor cortex using functional magnetic resonance imaging (fMRI).Methods Forty patients with ischemic stroke were randomly assigned to an observational group (n =20) or a control group (n =20).Both groups received conventional rehabilitation,while the observational group was additionally provided with action observation therapy for 8 weeks.Both groups were assessed using the Fugl-Meyer assessment (FMA) and the Barthel index (BI) before and after the 8 weeks of treatment and functional magnetic resonance imaging was performed before treatment.Two months after the treatment,nine patients of the experimental group and 8 of the control group who continued to receive their respective treatments after discharge were again assessed using functional magnetic resonance imaging.Results After the treatment the average FMA score and BI score of both the observational group and the control group had increased significantly.The increase in the average FMA score of the observational group was significantly greater than that of the control group.However,there was no significant difference between the two groups in the increases in BI score after 8 weeks of treatment.The fMRI results showed that there was a significantly greater rise in activity in the bilateral precentral gyrus,parietal lobe and the supplementary motor area of the patients in the observational group after the treatment compared with the control group.Conclusion Action observation therapy can improve upper extremity motor function and performance in the activities of daily living after ischemic stroke and induce changes in the excitability of the cerebral motor cortex.
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PURPOSE: Recent electrophysiological studies have shown that the sensorymotor cortex is activated during both actual action excuted by themselves and observation of action performed by other persons. Observation of action based on mirror neuron system can be used as a cognitive intervention to promote motor learning. The purpose of this study was to investigate the brain activity changes during action observation and action execution using EEG. METHODS: Thirty healthy volunteers participated and were requested to perform hand action and to observe the video of hand action performed by another person. The EEG activity was evaluated by a method which segregated the time-locked for each condition. To compare the differences between action observation and execution, the Mu suppression and the relative band power were analysed. RESULTS: The results showed significant mu suppression during the action observation and execution, but the differences between the two conditions were not observed. The relative band power showed a significant difference during the action observation and execution, but there were no differences between the two conditions. CONCLUSION: These results indicate that action execution and observation involve overlapping neural networks in the sensorymotor cortical areas, proposing positive changes on neurophysiology. We are expected to provide information related to the intervention of cognitive rehabilitation.
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Humans , Brain , Electroencephalography , Hand , Healthy Volunteers , Learning , Methods , Mirror Neurons , Neurophysiology , RehabilitationABSTRACT
The action of observing can be used as an effective rehabilitation paradigm, because it activates the mirror neuron system. However, it is difficult to fully use this paradigm because it is difficult to get patients to engage in watching video clips of exercise. In this study, we proposed a steady state visually evoked potential (SSVEP) based paradigm that could be used in a Brain Computer Interface, and examined its feasibility by investigating whether flickering video could activate the mirror neuron system and evoke SSVEPs at the same time. Twenty subjects were recruited and asked to watch the flickering videos at a rate of 20 Hz of upper limb motion and visual white noise, while an EEG signal was recorded. The mu rhythm (8–13 Hz) suppression and the SSVEP (19–21 Hz) evocation were analyzed from recorded EEG. The results showed that SSVEPs, evoked by the flickering stimulus, was observed in both conditions on O1 and O2, but the mu rhythm suppression on C3 and C4 was observed only in the exercise video condition. These results could signify that the flickering video is applicable for the BCI rehabilitation game, activating the mirror neuron system at the same time.
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Humans , Brain-Computer Interfaces , Electroencephalography , Evoked Potentials , Mirror Neurons , Noise , Rehabilitation , Stroke , Upper ExtremityABSTRACT
PURPOSE: Previous studies have reported that action observation training has beneficial effects on enhancing the motor task, such as balance and gait functions. On the other hand, there have been few studies combined with action observation training and auditory feedback. The purpose of this study was to determine the effects of action observation training with auditory feedback on the gait function in stroke patients with hemiparesis. METHODS: A total of 24 inpatients with post-stroke hemiparesis were assigned randomly to either an experimental group 1 (EG 1, n=8), experiment group 2 (EG 2, n=8), control group (CG, n=8, EG 1). The EG 2 and CG watched video clip demonstrating three functional walking tasks with auditory feedback, without auditory feedback, and showing a landscape image, respectively. The exercise program consisted of 30 minutes, five times a week, for four weeks. The participants were measured to 10MWT (10 m walk test), 6MWT (6 minutes walking distance test), TUG (timed up and go test), DGI (dynamic gait index), time and steps of F8WT (figure-of-8 walk test). RESULTS: In the intra-group comparison after the intervention, EG 1 and EG 2 showed a significantly different gait function (10MWT, 6MWT, DGI, TUG, F8WT) (p < 0.05). In the inter-group comparison after intervention, EG 1 showed significant improvements in the entire gait parameters and EG 2 only showed significant improvement in DGI and TUG compared to CG (p < 0.05). CONCLUSION: These findings show that action observation training with auditory feedback may be used beneficially for improving the gait function of stroke patients with hemiparesis.