Abstract
Action observation treatment (AOT) exploits a neurophysiological mechanism, matching an observed action on the neural substrates where that action is motorically represented. This mechanism is also known as mirror mechanism. In a typical AOT session, one can distinguish an observation phase and an execution phase. During the observation phase, the patient observes a daily action and soon after, during the execution phase, he/she is asked to perform the observed action at the best of his/her ability. Indeed, the execution phase may sometimes be difficult for those patients where motor impairment is severe. Although, in the current practice, the physiotherapist does not intervene on the quality of the execution phase, here, we propose a stimulation system based on neurophysiological parameters. This perspective article focuses on the possibility to combine AOT with a brain–computer interface system (BCI) that stimulates upper limb muscles, thus facilitating the execution of actions during a rehabilitation session. Combining a rehabilitation tool that is well-grounded in neurophysiology with a stimulation system, such as the one proposed, may improve the efficacy of AOT in the treatment of severe neurological patients, including stroke patients, Parkinson’s disease patients, and children with cerebral palsy.
Highlights
In Parkinson’s disease (PD) patients, during action observation, changes in beta oscillatory activity of the subthalamic nucleus occur, similar to those recorded over the motor cortex, suggesting that basal ganglia may play a role in the mirror mechanism [40]
The extracted features are sent to a data processing unit, which decides whether the verify in real time the progress of the patient, he/she could activate a data streaming toFES has to be applied, and how to tune the different channel parameters to make the wards their facility, in order to monitor the physiological signals acquired during movemovement as natural as possible
brain–computer interface system (BCI) may improve the performance of patients, whatever the gravity stimulation waves, to relax muscle fatigue
Summary
There is increasing empirical evidence that when individuals observe actions performed by other people, they automatically activate the brain neural structures responsible for the actual execution of the seen action [19]. In PD patients, during action observation, changes in beta oscillatory activity of the subthalamic nucleus occur, similar to those recorded over the motor cortex, suggesting that basal ganglia may play a role in the mirror mechanism [40] It is well-known that PD patients improve their motor performances when they obtain an external cue [41]. Patients impaired in performing distal hand/arm actions (i.e., grasping, manipulating) should practice these motor tasks, whereas those presenting with impairment of proximal arm actions (i.e., reaching objects, coding objects in space) should focus on these motor tasks This individual training program has the potential to be applied in a tele-rehabilitation setting. The current health emergency due to the COVID-19 pandemic has brought further the use of home-based rehabilitation strategies; in this context, telerehabilitation can help to stop the spread of contagion, while assuring patients with motor impairment the possibility of following a regular rehabilitation program
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