Action observation for upper limb rehabilitation after stroke

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

doi:10.1002/14651858.cd011887.pub2

Cited by 48 publications

(38 citation statements)

References 53 publications

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“…The results indicated that both groups achieved significant benefits in the Fugl-Meyer scale scores and that the experimental group presented superior results. This finding corroborates previous studies [12][13][14][15][16][17] that observed improvement in motor impairment of the affected upper limb after training with AO. The improvement can be attributed to the fact that exercises with AO stimulate mirror neurons 22 and the cerebellar-thalamic-cortical system responsible for externally guided movements 10 .…”

Section: Discussionsupporting

confidence: 93%

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Exercises with action observation contribute to upper limb recovery in chronic stroke patients: a controlled clinical trial

Lima

Christofoletti

2020

Motriz: rev. educ. fis.

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To investigate the effects of an exercise program with action observation versus conventional physical therapy on upper limb functionality in chronic stroke subjects. Methods: In this controlled clinical trial, thirtyfive stroke patients were divided into two groups, experimental group, comprising eighteen patients that received an exercise program with action observation; and a control group, comprising seventeen patients that received conventional exercise program. Functional recovery was assessed with the Fugl-Meyer Scale, manual dexterity was assessed with the Box and Blocks test, and the functional use of the affected upper limb was assessed with the Reach scale. Evaluations occurred at baseline, after three and six months of intervention. Statistical analyses were performed with the Repeated Measures Analysis of Variance and the Friedman test, under a 5% significance. Results: Both interventions provided benefits to chronic stroke patients. Exercise program with action observation presented better results on motor recovery (p < 0.001) and functional use of the affected limb (p < 0.001) when compared with conventional therapy. Both treatments improved the manual dexterity of the participants (p = 0.002), but in a similar way (p = 0.461). Conclusion: A six-month exercise program with action observation provided benefits on functional recovery and functional use of an affected upper limb in chronic stroke patients. Exercises with action observation demonstrated the potential for improving affected upper limb in chronic stroke patients.

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Section: Discussionsupporting

confidence: 93%

“…Previous studies using AO showed positive results in the recovery of the affected upper limb in stroke [12][13][14][15][16][17] . There were improvements in functionality, on the ability to perform activities of daily living and on manual dexterity.…”

Section: Introductionmentioning

confidence: 99%

Exercises with action observation contribute to upper limb recovery in chronic stroke patients: a controlled clinical trial

Lima

Christofoletti

2020

Motriz: rev. educ. fis.

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“…In recent years, action observation (AO), in which patients observe a specific video describing an action to recruit the relevant action-related mirror neurons and enable a direct matching between others’ gestures and their own motor system, has emerged as a novel and effective option as an add-on intervention to rehabilitation therapy ( Hetu et al, 2010 ; Sale and Mattingley, 2013 ; Bassolino et al, 2014 ; Vesia et al, 2019 ). To date, this approach has been successfully applied in the rehabilitation of upper limb motor functions in chronic stroke patients ( Borges et al, 2018 ), in the language rehabilitation of post-stroke aphasia patients ( Gili et al, 2017 ), in motor recovery of Parkinson’s disease patients ( Pelosin et al, 2013 ), including those presenting with freezing of gait ( Pelosin et al, 2018 ), and in children with cerebral palsy ( Kirkpatrick et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Activation Patterns in Mirror Neurons and the Swallowing Network During Action Observation and Execution: A Task-Based fMRI Study

Jing

Lin

et al. 2020

Front. Neurosci.

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Background: Observation of a goal-directed motor action can excite the respective mirror neurons, and this is the theoretical basis for action observation (AO) as a novel tool for functional recovery during stroke rehabilitation. To explore the therapeutic potential of AO for dysphagia, we conducted a task-based functional magnetic resonance imaging (fMRI) study to identify the brain areas activated during observation and execution of swallowing in healthy participants. Methods: Twenty-nine healthy volunteers viewed the following stimuli during fMRI scanning: an action-video of swallowing (condition 1, defined as AO), a neutral image with a Chinese word for "watching" (condition 2), and a neutral image with a Chinese word for "swallowing" (condition 3). Action execution (AE) was defined as condition 3 minus condition 2. One-sample t-tests were performed to define the brain regions activated during AO and AE. Results: Many brain regions were activated during AO, including the middle temporal gyrus, inferior frontal gyrus, pre-and postcentral gyrus, supplementary motor area, hippocampus, brainstem, and pons. AE resulted in activation of motor areas as well as other brain areas, including the inferior parietal lobule, vermis, middle frontal gyrus, and middle temporal gyrus. Two brain areas, BA6 and BA21, were activated with both AO and AE. Conclusion: The left supplementary motor area (BA6) and left middle temporal gyrus (BA21), which contains mirror neurons, were activated in both AO and AE of swallowing. In this study, AO activated mirror neurons and the swallowing network in healthy participants, supporting its potential value in the treatment of dysphagia.

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“…Previous studies have demonstrated that robot-assisted training is effective in promoting upper extremity muscle strength and motor function after stroke [ 11 ]. Additionally, action observation treatment can enhance the effects of physical and occupational therapy by increasing neural activation [ 16 ]. However, compared with conventional therapy, the results fail to show a superior effect in arm function and ADL.…”

Section: Discussionmentioning

confidence: 99%

“…Action observation therapy (AOT) has been applied as an alternative or complement to another approach to rebuild motor function for stroke rehabilitation and was developed on the neurophysiological basis of the mirror neuron system (MNS) [ 15 , 16 ]. Action observation therapy consists of action observation followed by action imitation and execution, considering that both processes share the matching cerebral motor network.…”

Section: Introductionmentioning

confidence: 99%

Action observation treatment-based exoskeleton (AOT-EXO) for upper extremity after stroke: study protocol for a randomized controlled trial

Chen

Xia

et al. 2021

Trials

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Background Stroke produces multiple symptoms, including sensory, motor, cognitive and psychological dysfunctions, among which motor deficit is the most common and is widely recognized as a major contributor to long-term functional disability. Robot-assisted training is effective in promoting upper extremity muscle strength and motor impairment recovery after stroke. Additionally, action observation treatment can enhance the effects of physical and occupational therapy by increasing neural activation. The AOT-EXO trial aims to investigate whether action observation treatment coupled with robot-assisted training could enhance motor circuit activation and improve upper extremity motor outcomes. Methods The AOT-EXO trial is a multicentre, prospective, three-group randomized controlled trial (RCT). We will screen and enrol 132 eligible patients in the trial implemented in the Department of Rehabilitation Medicine of Tongji Hospital, Optical Valley Branch of Tongji Hospital and Hubei Province Hospital of Integrated Chinese & Western Medicine in Wuhan, China. Prior to study participation, written informed consent will be obtained from eligible patients in accordance with the Declaration of Helsinki. The enrolled stroke patients will be randomized to three groups: the CT group (conventional therapy); EXO group (exoskeleton therapy) and AOT-EXO group (action observation treatment-based exoskeleton therapy). The patients will undergo blinded assessments at baseline, post-intervention (after 4 weeks) and follow-up (after 12 weeks). The primary outcome will be the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Secondary outcomes will include the Action Research Arm Test (ARAT), modified Barthel Index (MBI), kinematic metrics assessed by inertial measurement unit (IMU), resting motor threshold (rMT), motor evoked potentials (MEP), functional magnetic resonance imaging (fMRI) and safety outcomes. Discussion This trial will provide evidence regarding the feasibility and efficacy of the action observation treatment-based exoskeleton (AOT-EXO) for post-stroke upper extremity rehabilitation and elucidate the potential underlying kinematic and neurological mechanisms. Trial registration Chinese Clinical Trial Registry ChiCTR1900026656. Registered on 17 October 2019.

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Action observation for upper limb rehabilitation after stroke

Cited by 48 publications

References 53 publications

Exercises with action observation contribute to upper limb recovery in chronic stroke patients: a controlled clinical trial

Exercises with action observation contribute to upper limb recovery in chronic stroke patients: a controlled clinical trial

Comparison of Activation Patterns in Mirror Neurons and the Swallowing Network During Action Observation and Execution: A Task-Based fMRI Study

Action observation treatment-based exoskeleton (AOT-EXO) for upper extremity after stroke: study protocol for a randomized controlled trial

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