Action observation training to improve motor function recovery: a systematic review

Abstract

Following the discovery of Mirror Neuron System (MNS), Action Observation Training (AOT) has become an emerging rehabilitation tool to improve motor functions both in neurologic and orthopedic pathologies.The aim of this study is to present the state of the art on the use of AOT in experimental studies to improve motor function recovery in any disease.The research was performed in PubMed, PEDro, Embase, CINAHL and Cochrane Central Register of Controlled Trials (last search July 2015). Randomized controlled trials (RCTs) that analyse efficacy of AOT for recovery of motor functions, regardless of the kind of disease, were retrieved. The validity of the included studies was assessed using the Cochrane Collaboration tool for evaluating risk of bias.Twenty RCTs were eligible. Four studies showed AOT efficacy in improving upper limb functional recovery in participants with chronic stroke, two studies in sub-acute ones and one in acute ones. Six articles suggested its effectiveness on walking performance in chronic stroke individuals, and three of them also suggested an efficacy in improving balance. The use of AOT was also recommended in individuals with Parkinson’s disease to improve autonomy in activities of daily living, to improve spontaneous movement rate of self-paced finger movements and to reduce freezing of gait. Other two studies also indicated that AOT improves upper limb motor function in children with cerebral palsy. The last two studies, showed the efficacy of AOT in improving motor recovery in postsurgical orthopedic participants. Overall methodological quality of the considered studies was medium.The majority of analyzed studies suggest the efficacy of AOT, in addition to conventional physiotherapy, to improve motor function recovery in individuals with neurological and orthopedic diseases. However, the application of AOT is very heterogeneous in terms of diseases and outcome measures assessed, which makes it difficult to reach, to date, any conclusion that might influence clinical practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s40945-015-0013-x) contains supplementary material, which is available to authorized users.

Motor Imagery during Action Observation: A Brief Review of Evidence, Theory and Future Research Opportunities

“…Although distinct brain structures are identifiable for AO, MI and execution individually (Filimon et al, 2007, 2015; Munzert et al, 2008; Lorey et al, 2013), the case for using MI and AO in motor learning and rehabilitation has been largely predicated on the degree of neural overlap shared with motor execution. It is important to note, however, that while the majority of evidence supports the effectiveness of MI and AO as independent instruction techniques, there is evidence to the contrary (see Braun et al, 2013; Gatti et al, 2013; Sarasso et al, 2015). Furthermore, it is difficult to draw clear conclusions on the mixed results provided across studies that have compared the potential advantages of motor imagery vs. action observation , both on motor function and neural processes (e.g., Porro et al, 2007; Filimon et al, 2007, 2015; Szameitat et al, 2012; Gatti et al, 2013; Gonzalez-Rosa et al, 2015; Helm et al, 2015).…”

The Activation of the Mirror Neuron System during Action Observation and Action Execution with Mirror Visual Feedback in Stroke: A Systematic Review

“…Based on this theory, researchers believe that the motor cortex could be primed by activating the MNS, thus boosting the efficacy of standardized rehabilitation for patients after strokes [ 17 , 20 ]. Subsequently, various rehabilitative strategies, aimed at facilitating the motor cortex through activating the MNS, have been applied in stroke rehabilitation, including action observation training (AOT) [ 21 , 22 ] and action execution with MVF [ 23 ]. AOT usually consists of a session of AO followed by a session of imitating the observed action [ 22 ].…”

Motor Imagery during Action Observation of Locomotor Tasks Improves Rehabilitation Outcome in Older Adults after Total Hip Arthroplasty

“…To counteract at least some of these risk factors, mental simulation techniques such as action observation (AO) or motor imagery (MI) have been proposed as feasible alternatives to stimulate the motor system [ 10 , 11 ]. The AO therapy requires subjects to observe a video clip or watch actions performed by an operator [ 12 , 13 ] while MI represents the mental simulation of motor actions without any corresponding motor output [ 14 ].…”