Action Observation for Rehabilitation After Stroke

Borges, Lorenna Raquel Dantas de Macedo; Fernandes, Aline Braga Galvão Silveira; Melo, Luciana Protásio de; Guerra, Ricardo Oliveira; Campos, Tânia

doi:10.1161/strokeaha.118.024297

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“…However, it is unclear how the brain maps visual information onto motor circuits for learnig. Here, we test the idea that the somatosensory system and, specifically, the primary somatosensory cortex (S1), plays a role in motor learning by VFT [ 8 ]. S1 cortical processing was assessed before and after observation by measuring somatosensory evoked potentials (SEPs) associated with median nerve stimulation.…”

Section: Introductionmentioning

confidence: 99%

Visual feedback therapy for restoration of upper limb function of stroke patients

Zhu

Zeng

Shi

et al. 2020

International Journal of Nursing Sciences

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Objective To investigate the effects of mirror neuron theory-based visual feedback therapy (VFT) on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging (fMRI). Methods Hemiplegic stroke patients were randomly divided into two groups: a VFT group and a control (CTL) group. Sixteen patients in the VFT group received conventional rehabilitation (CR) and VFT for 8 weeks, while 15 patients in the CTL group received only CR. The Barthel Index (BI) was used to assess the activities of daily living at baseline and the 8 th week of the recovery training period. The Fugl–Meyer assessment (FMA) scale, somatosensory evoked potential (SEP), and fMRI were used to evaluate the recovery effect of the training therapies. The latencies and amplitudes of N9 and N20 were measured. Before recovery training, fMRI was performed for all patients in the VFT and CTL groups. In addition, 17 patients (9 in the VFT group and 8 in the CTL group) underwent fMRI for follow-up 2 months after treatment. Qualitative data were analyzed using the χ 2 test. The independent sample t -test was used to compare normally distributed data among different groups, the paired sample t -test was used to compare data between groups, and the non-parametric test was used to comparing data without normal distribution among groups. Results There were no significant differences between the VFT and CTL group in all indexes. However, after 8 weeks of recovery training, these indexes were all significantly improved ( P < 0.05). As compared with the CTL group, the FMA scores, BI, and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved ( P < 0.05). Two months after recovery training, fMRI showed that the degree of activation of the bilateral central anterior gyrus, parietal lobe, and auxiliary motor areas was significantly higher in the VFT group than the CTL group ( P < 0.05). Conclusions VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients. The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex. SEP amplitudes increased only for patients who participated in visual feedback. VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.

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Section: Introductionmentioning

confidence: 99%