Abstract
This study aimed at determining whether the combination of action observation and motor imagery (AO + MI) of locomotor tasks could positively affect rehabilitation outcome after hip replacement surgery. Of initially 405 screened participants, 21 were randomly split into intervention group (N = 10; mean age = 64 y; AO + MI of locomotor tasks: 30 min/day in the hospital, then 3×/week in their homes for two months) and control group (N = 11, mean age = 63 y, active controls). The functional outcomes (Timed Up and Go, TUG; Four Step Square Test, FSST; and single- and dual-task gait and postural control) were measured before (PRE) and 2 months after surgery (POST). Significant interactions indicated better rehabilitation outcome for the intervention group as compared to the control group: at POST, the intervention group revealed faster TUG (p = 0.042), FSST (p = 0.004), and dual-task fast-paced gait speed (p = 0.022), reduced swing-time variability (p = 0.005), and enhanced cognitive performance during dual tasks while walking or balancing (p < 0.05). In contrast, no changes were observed for body sway parameters (p ≥ 0.229). These results demonstrate that AO + MI is efficient to improve motor-cognitive performance after hip surgery. Moreover, only parameters associated with locomotor activities improved whereas balance skills that were not part of the AO + MI intervention were not affected, demonstrating the specificity of training intervention. Overall, utilizing AO + MI during rehabilitation is advised, especially when physical practice is limited.
Highlights
Prolonged immobilization and inactivity after injury and/or surgery may lead to serious motor and cognitive dysfunctions, especially in older adults [1, 2]
As older adults indicated to have some problems to watch and at the same time “feel the sensations that arise from doing the task”, we presented first the video and asked them to do action observation (AO) + motor imagery (MI) followed by a period in which subjects should close their eyes and imagine the sensations that arise from doing the task (MI)
As subjects indicated difficulties to watch and at the same time “feel the sensations that arise from doing the task”, we presented first the video and asked them to do AO + MI followed by a period in which subjects should close their eyes and imagine the sensations that arise from doing the task (MI)
Summary
Prolonged immobilization and inactivity after injury and/or surgery may lead to serious motor and cognitive dysfunctions, especially in older adults [1, 2]. Immobilization in the acute period after hip arthroplasty has become more and more frequent in this population due to the increasing amount of people suffering from osteoporosis, which can result in hip fractures [3]. Immobilization leads to several impairments of motor function [5]. Motor impairments that follow short periods of inactivity are believed to be principally driven by changes occurring at the cortical level rather than the muscular level [6,7,8]. A significant reduction of the cortical motor area representing the immobilized limb could be observed [9]
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