Action Observation Treatment Research Articles

Action observation intervention using three-dimensional movies improves the usability of hands with distal radius fractures in daily life-A nonrandomized controlled trial in women.

Prolonged immobilization of joints after distal radius fracture (DRF) causes cerebral disuse-dependent plasticity (DDP) and deterioration of upper extremity function. Action observation therapy (AOT) can improve DDP. This nonrandomized controlled trial (UMIN 000039973) tested the hypothesis that AOT improves hand-use difficulties during activities of daily living in patients with DRF. Right-handed women with volar locking plate fixation for DRF were divided into AOT and Non-AOT groups for a 12-week intervention. The primary outcome was difficulty in using the fractured hand, assessed with the Japanese version of the Patient-related Wrist Evaluation (PRWE). The secondary outcomes were range of motion (ROM) of the injured side and gap between measured ROM and patient-estimated ROM. The survey was administered immediately post operation and at postoperative weeks 4, 8, and 12. The AOT group used a head-mounted display and three-dimensional video during ROM exercises. The Non-AOT group used active ROM exercises alone. A generalized linear model (GLM) was used to confirm interactions and main effects by group and time period, and multiple comparisons were performed. Thirty-five patients were assigned to the AOT group (n = 18, median age, 74 years) or the Non-AOT group (n = 17, median age, 70 years). In the GLM, PRWE Total, PRWE Specific, and PRWE Usual scores revealed interactions between groups and periods. The post-hoc test revealed that the PRWE Specific scores (z = 3.43, p = 0.02) and PRWE Usual scores (z = 7.53, p<0.01) were significantly lower in the AOT group than in the Non-AOT group at 4 weeks postoperatively, whereas PRWE Total scores (z = 3.29, p = 0.04) were lower at 8 weeks postoperatively. These results suggested that AOT can improve hand-use difficulties in right-handed women after DRF surgery. AOT positively affects the motor imagery of patients with DRF and can reverse the patient's perceived difficulty in using the fractured hand during rehabilitation.

The effect and mechanism of motor imagery based on action observation treatment on dysphagia in Wallenberg Syndrome: a randomized controlled trial.

The effect of motor imagery applied to dysphagia patients with Wallenberg syndrome has not yet been reported. This trial aimed to investigate the effect and mechanism of motor imagery based on action observation treatment in the rehabilitation of patients with dysphagia in Wallenberg syndrome. A randomized controlled trial. The setting was in-patient. Thirty patients with dysphagia of Wallenberg syndrome. The patients were divided into the experimental group and the control group. Both groups received conventional dysphagia treatment, and the experimental group underwent the addition of motor imagery based on action observation treatment to the control group once a day for 14 days. Overall swallowing function was assessed with specific scales before and after intervention. Meanwhile, the functional near infrared spectroscopy was used to detect changes in cerebral hemodynamics during the execution of volitional swallowing task and swallowing motor imagery. The standardized swallowing assessment score (P=0.030), Murray secretion scale score (P=0.044) and swallowing quality of life score (P=0.011) of the experimental group improved better than those of the control group. In addition, multiple brain regions of the cortical presented extensive activation (P<0.05) during the execution of swallowing motor imagery. Moreover, there were significant differences (P<0.05) in brain regions pre-motor and supplementary motor cortex, right primary motor cortex, and right primary somatosensory cortex of the experimental group before and after treatment. The present study indicated that motor imagery based on action observation treatment could improve swallowing function for patients with dysphagia of Wallenberg syndrome as an add-on training. As a top-down rehabilitation training, the mechanism of this therapy may be related to the selective activation of mirror neuron system. Motor imagery based on action observation treatment can be implemented as part of the therapeutic for dysphagia of Wallenberg syndrome.

Focal muscle vibration and action observation: a combined approach for muscle strengthening.

Muscle strength is essential for autonomy in daily activities and performance in sports activities. Yet, conventional strength training is challenging during recovery from pathological conditions. This study investigates a novel combined intervention employing Focal Muscle Vibration (FMV) and Action Observation (AO) to enhance muscle strength. Twenty-seven healthy volunteers (18 females and 9 males, aged 22 to 42 years) were enrolled for an intervention-control study comparing 2 groups: the intervention group received AO treatment with FMV on the right leg, and the control group underwent only FMV on the right leg. This design allowed the comparison of four conditions: FMV+AO (intervention group, right leg), AO alone (intervention group, left leg), FMV alone (control group, right leg), and no-treatment NT (control group, left leg). The treatment, conducted five times a week (Mon-Fri) for two weeks, involved a 20-minute session of FMV on the right quadriceps, coupled, for the intervention group, with the observation of a gym training video. The assessments of Maximum Voluntary Contraction (MVC), and fatigue coefficient (FC) expressed at knee extension bilaterally were measured at the beginning (T0), after the first week (T1), at the end of treatment (T2), and one-week post-intervention for the follow-up (T3). The FMV+AO group demonstrated a significant improvement in MVC over time, reaching statistical significance at T2 and maintaining the gain at T3. In contrast, all the other conditions demonstrated milder MVC increases without statistical significance. FC did not differ significantly in any condition. The combination of FMV and AO optimized muscle strengthening, offering insights for targeted treatments in various settings.

Effectiveness of action observation treatment based on pathological model in hemiplegic children: a randomized-controlled trial.

Action observation treatment (AOT) is an innovative therapeutic approach consisting in the observation of actions followed by their subsequent repetition. The standard version of AOT consists in the observation/imitation of a typically developed individual, which is proposed as model (TDM-AOT). This study aims to compare the effectiveness of AOT based on a pathological ameliorative model (PAM-AOT) versus TDM-AOT in improving upper limb ability in children with unilateral cerebral palsy (UCP). The study consists in a prospective randomized controlled, evaluator-blinded trial (RCT), with two active arms, designed to evaluate the effectiveness of AOT based on pathological model (PAM-AOT) as compared to a standard AOT based on TDM (TDM-AOT). The 3-week AOT program was administered in a clinical setting. For some patients, the treatment was delivered at participant's home with the remote support of the physiotherapist (tele-rehabilitation). Twenty-six children with UCP (mean age 10.5±3.09 years; 14 females) participated in the study, with the experimental group observing a pathological model and the control group observing a typically developed model. Motor assessments included unimanual and bimanual ability measures conducted at T0 (baseline, before the treatment), T1 (3 weeks after T0), T2 (8-12 weeks after treatment) and T3 (24-28 weeks after treatment); a subset of 16 patients also underwent fMRI motor assessment. Generalized Estimating Equations models were used for statistical analysis. Both groups showed significant improvement in bimanual function (GEE, Wald 106.16; P<0.001) at T1 (P<0.001), T2 (P<0.001), and T3 (P<0.001). Noteworthy, the experimental group showed greater improvement than the control group immediately after treatment (P<0.013). Both groups exhibited similar improvement in unimanual ability (GEE, Wald 25.49; P<0.001). The fMRI assessments revealed increased activation of ventral premotor cortex after treatment in the experimental compared with control group (GEE, Wald 6.26; P<0.012). Overall, this study highlights the effectiveness of PAM-AOT in achieving short-term improvement of upper limb ability in children with UCP. These findings have significant implications for rehabilitative interventions based on AOT in hemiplegic children, by proposing a non-traditional approach focused on the most functional improvement achievable by imitating a pathological model.

Top-down and bottom-up stimulation techniques combined with action observation treatment in stroke rehabilitation: a perspective.

Stroke is a central nervous system disease that causes structural lesions and functional impairments of the brain, resulting in varying types, and degrees of dysfunction. The bimodal balance-recovery model (interhemispheric competition model and vicariation model) has been proposed as the mechanism of functional recovery after a stroke. We analyzed how combinations of motor observation treatment approaches, transcranial electrical (TES) or magnetic (TMS) stimulation and peripheral electrical (PES) or magnetic (PMS) stimulation techniques can be taken as accessorial physical therapy methods on symptom reduction of stroke patients. We suggest that top-down and bottom-up stimulation techniques combined with action observation treatment synergistically might develop into valuable physical therapy strategies in neurorehabilitation after stroke. We explored how TES or TMS intervention over the contralesional hemisphere or the lesioned hemisphere combined with PES or PMS of the paretic limbs during motor observation followed by action execution have super-additive effects to potentiate the effect of conventional treatment in stroke patients. The proposed paradigm could be an innovative and adjunctive approach to potentiate the effect of conventional rehabilitation treatment, especially for those patients with severe motor deficits.

Skin Tone: The Missing Piece in Action Observation Intervention Poststroke

Abstract Date Presented 04/22/2023 Action observation has been documented as an evidence-based intervention for upper extremity motor recovery poststroke. The results from this Critically Appraised Topic demonstrate a lack of documentation regarding the skin tone displayed in the videos used for action observation intervention. Consideration should be given to displaying videos with concordant race, skin tone, and gender of the client. Such inclusivity may increase positive outcomes for participants. Primary Author and Speaker: Krystal Robinson-Bert

The Effect of Swallowing Action Observation Therapy on Resting fMRI in Stroke Patients with Dysphagia.

Many stroke victims have severe swallowing problems. Previous neuroimaging studies have found that several brain regions scattered in the frontal, temporal, and parietal lobes, such as Brodmann's areas (BA) 6, 21, and 40, are associated with swallowing function. This study sought to investigate changes in swallowing function and resting-state functional magnetic resonance imaging (rs-fMRI) in stroke patients with dysphagia following action observation treatment. It also sought to detect changes in brain regions associated with swallowing in stroke patients. In this study, 12 healthy controls (HCs) and 12 stroke patients were recruited. Stroke patients were given 4 weeks of action observation therapy. In order to assess the differences in mfALFF values between patients before treatment and HCs, the fractional amplitude of low-frequency fluctuations (fALFF) in three frequency bands (conventional frequency band, slow-4, and slow-5) were calculated for fMRI data. The significant brain regions were selected as regions of interest (ROIs) for subsequent analysis. The mfALFF values were extracted from ROIs of the three groups (patients before and after treatment and HCs) and compared to assess the therapeutic efficacy. In the conventional band, stroke patients before treatment had higher mfALFF in the inferior temporal gyrus and lower mfALFF in the calcarine fissure and surrounding cortex and thalamus compared to HCs. In the slow-4 band, there was no significant difference in related brain regions between stroke patients before treatment and HCs. In the slow-5 band, stroke patients before treatment had higher mfALFF in inferior cerebellum, inferior temporal gyrus, middle frontal gyrus, and lower mfALFF in calcarine fissure and surrounding cortex compared to HCs. We also assessed changes in aberrant brain activity that occurred both before and after action observation therapy. The mfALFF between stroke patients after therapy was closed to HCs in comparison to the patients before treatment. Action observation therapy can affect the excitability of certain brain regions. The changes in brain function brought about by this treatment may help to further understand the potential mechanism of network remodeling of swallowing function.

Action Observation Treatment for Upper Limb Rehabilitation in Patients With Stroke: Protocol for a Multicenter Randomized Controlled Trial

In the last few years, new noninvasive strategies have emerged as rehabilitative treatments for patients with stroke. Action observation treatment (AOT) is a rehabilitation approach based on the properties of the mirror neuron system with a positive impact on modifying cortical activation patterns and improving the upper limb kinematics. AOT involves the dynamic process of observing purposeful actions with the intention of imitating and then practicing those actions. In recent years, several clinical studies suggested the effectiveness of AOT in patients with stroke to improve motor recovery and autonomy in activities of daily living. However, a deeper knowledge of the behavior of the sensorimotor cortex during AOT seems to be essential. The aim of this clinical trial, conducted in 2 neurorehabilitation centers and in patients' homes, is to investigate the effectiveness of AOT in patients with stroke, confirming the translational power of a tailored treatment. Particular emphasis will be placed on the predictive value of neurophysiological biomarkers. In addition, the feasibility and impact of a home-based AOT program will be investigated. A 3-arm, assessor-blinded, randomized controlled trial will be performed by enrolling patients with stroke in the chronic stage. A total of 60 participants will be randomly allocated to receive 15 sessions of AOT with different protocols (AOT at the hospital, AOT at home, and sham AOT), 3 sessions per week. The primary outcome will be assessed using the Fugl-Meyer Assessment-Upper Extremity scores. Secondary outcomes will be clinical, biomechanical, and neurophysiological assessment. The study protocol is part of a project (project code GR-2016-02361678) approved and funded by the Italian Ministry of Health. The study began with the recruitment phase in January 2022, and enrollment was expected to end in October 2022. Recruitment is now closed (December 2022). The results of this study are expected to be published in spring 2023. Upon completion of the analyses, we will examine the preliminary effectiveness of the intervention and neurophysiological outcomes. This study will be used to evaluate the effectiveness of 2 different AOT scenarios (ie, AOT at the hospital and AOT at home) in patients with chronic stroke and to assess the predictive value of neurophysiological biomarkers. Specifically, we will attempt to induce the functional modification of the cortical components by exploiting the features of the mirror neuron system, demonstrating relevant clinical, kinematic, and neurophysiological changes after AOT. With our study, we also want to provide, for the first time in Italy, the AOT home-based program while assessing its feasibility and impact. ClinicalTrials.gov NCT04047134; https://clinicaltrials.gov/ct2/show/NCT04047134. DERR1-10.2196/42094.

The effect of motor imagery and action observation in the rehabilitation of lower limb injuries: A scoping review

Objective To synthesize research literature, which has investigated the application of motor imagery and action observation in rehabilitation protocols. Specifically, we aimed to review the implementation of motor imagery and action observation in the rehabilitation of lower limb injuries. Methods This scoping review followed Arksey and O’Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines for scoping reviews checklist. The Medline (PubMed), Cochrane Library, Scopus, and Web of Science databases were searched for controlled clinical trials published between 2010 and 2021 using key search terms. Primary articles were screened for inclusion based upon applying motor imagery and action observation as a rehabilitation protocol (independently or in combination) after sustaining an injury or undergoing surgery. Data were charted by extracting the exercise duration, frequency, and the number of weeks from the rehabilitative intervention protocols, and the measured clinical outcomes (pain, range of motion, muscle activity, and functional outcomes). Results The initial database search resulted in 1367 articles, with 1352 excluded after screening, resulting in a total of 15 articles eligible for inclusion in the review. Six of the included articles included an action observation intervention, eight studies a motor imagery intervention, and a single study included combined motor imagery and action observation approach. The motor imagery and action observation techniques were able to improve clinical outcomes, including daily activity, functional movement, rage of motion, pain, and muscle strength. Conclusion Motor imagery and action observation interventions may be effective to improve rehabilitative outcomes of lower limb injuries, thus its application should be considered alongside standard treatment protocols.

The Effects of Action Observation Therapy as a Rehabilitation Tool in Parkinson's Disease Patients: A Systematic Review.

During Action Observation (AO), patients observe human movements that they then try to imitate physically. Until now, few studies have investigated the effectiveness of it in Parkinson’s disease (PD). However, due to the diversity of interventions, it is unclear how the dose and characteristics can affect its efficiency. We investigated the AO protocols used in PD, by discussing the intervention features and the outcome measures in relation to their efficacy. A search was conducted through MEDLINE, Scopus, Cochrane, and WoS until November 2021, for RCTs with AO interventions. Participant’s characteristics, treatment features, outcome measures, and main results were extracted from each study. Results were gathered into a quantitative synthesis (MD and 95% CI) for each time point. Seven studies were included in the review, with 227 participants and a mean PEDro score of 6.7. These studies reported positive effects of AO in PD patients, mainly on walking ability and typical motor signs of PD like freezing of gait. However, disagreements among authors exist, mainly due to the heterogeneity of the intervention features. In overall, AO improves functional abilities and motor control in PD patients, with the intervention dose and the characteristics of the stimulus playing a decisive role in its efficacy.

EFFECTS OF ACTION OBSERVATION TREATMENT ON UPPER LIMB MOTOR FUNCTION IN CHRONIC STROKE PATIENTS

The rate of cerebrovascular accident is keep on increasing in Pakistan which cause major disability in affected person. In developed countries it has been reported that an action observation treatment for rehabilitation, promotes motor function of upper limb in stroke population.Objective: To find out effects of action observation treatment on upper limb motor functions of chronic stroke patients.Study Design: A randomized control trial with registered number NCT05084820.Place and Duration of study:Fourteen chronic stroke patients were taken from Umer hospital and Riphah rehab center Lahore. Total duration of study was 6 months.Materials and method:A randomized control trial was done containing total 14 chronic stroke patients. Patients in experimental group were given action observationtreatment three days per week for one month along with conventional physiotherapy treatment. Patients in conventional group, received strengthening exercises, reach and grasp of hand, stretch of hand muscles. Modified Barthel Index was used to measure function of upper limb and Fugl-Meyer Assessment for upper extremity (FMA-UE) for assessment of motor function. Statistical analysis was done by using SPSS 21.Results: There were significant difference in MBI and FMA-UE score, P value was &lt;0.05, but sensation and joint pain from FMA-UE tool P value was &gt;0.05 which was non-significant.Conclusion:Action observation treatment together with conventional treatment was an effective treatment approach on improving motor function of upper limb in chronic stroke patients.

A Repertoire of Virtual-Reality, Occupational Therapy Exercises for Motor Rehabilitation Based on Action Observation

There is a growing interest in action observation treatment (AOT), i.e., a rehabilitative procedure combining action observation, motor imagery, and action execution to promote the recovery, maintenance, and acquisition of motor abilities. AOT studies employed basic upper limb gestures as stimuli, but—in principle—the AOT approach can be effectively extended to more complex actions like occupational gestures. Here, we present a repertoire of virtual-reality (VR) stimuli depicting occupational therapy exercises intended for AOT, potentially suitable for occupational safety and injury prevention. We animated a humanoid avatar by fitting the kinematics recorded by a healthy subject performing the exercises. All the stimuli are available via a custom-made graphical user interface, which allows the user to adjust several visualization parameters like the viewpoint, the number of repetitions, and the observed movement’s speed. Beyond providing clinicians with a set of VR stimuli promoting via AOT the recovery of goal-oriented, occupational gestures, such a repertoire could extend the use of AOT to the field of occupational safety and injury prevention.

Combining Action Observation Treatment with a Brain-Computer Interface System: Perspectives on Neurorehabilitation.

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.

Efficacy of Action Observation for Upper Limb Motor Deficit in Acute Stroke Participants

Introduction: Action Observation (AO) is a multisensory approach encompassing motor, somatosensory and cognitive rehabilitation. Several Studies have proved the effects of action observation on recovery of motor functions in chronic stroke survivors. However, the effect of action observation strategy on acute stroke participants remains unclear. The objective of this study was to find out the effectiveness of action observation to improve upper limb function in acute stroke.&#x0D; Methods: 28 acute stoke participants were selected based on inclusion and exclusion criteria and randomly assigned into two groups based on computer generated randomization. Action observation training group (AO) received action observation training and conventional group received conventional physiotherapy. Both the groups received 45 minutes session per day for the total duration of 10 days.&#x0D; Results: Upper limb functions were measured using Fugl Myer upper limb component (FMA) and action research arm test (ARAT)at the baseline and after the intervention. Compared with the conventional training group, AO group showed significant improvement in ARAT but no significant difference between the groups in FMA.&#x0D; Conclusion: In conclusion Action observation treatment may become a useful strategy in rehabilitation of acute stroke participants.

Action observation treatment. A brief overview of a new tool for rehabilitation and education in the clinical, neuropsychological and sports fields.

In recent years, research in the clinical, neuropsychological, educational and sports fields has contributed to the development of numerous and different therapeutic interventions, radically changing the ability to deal with problems of various kinds in these areas. The objective of this brief review illustrates the new rehabilitation and educational approach of AOT (ACTION OBSERVATION TREATMENT), which exploits the neurophysiological mechanism of mirror neurons. Its potential for motor recovery could be used in clinical, educational, neuropsychological and sports settings. Negli ultimi anni, la ricerca in ambito clinico, neuropsicologico, educativo e sportivo, ha contribuito allo sviluppo di numerosi e diversi interventi terapeutici cambiando radicalmente la capacita di affrontare i problemi di diversa natura in questi ambiti. L’obiettivo di questa breve review illustra il nuovo approccio riabilitativo ed educativo dell’ AOT (ACTION OBSERVATION TREATMENT), che sfrutta il meccanismo neurofisiologico dei neuroni specchio. Il suo potenziale per il recupero motorio potrebbe essere utilizzabile in ambito clinico, educativo, neuropsicologico e sportivo

Effects of a Combined Motor Imagery and Action Observation Intervention on Vascular Cognitive Impairment: A Randomized Pilot Study.

The aim of the study was to identify the effects of combined motor imagery and action observation therapy on vascular cognitive impairment. Thirty vascular cognitive impairment patients were randomly assigned into three groups. Cognitive training group was given conventional cognitive training, motor imagery + action observation group was treated with motor imagery and action observation therapy, and mixed therapy group was given conventional cognitive training and motor imagery + action observation therapy, for 8 wks continuously. The Montreal Cognitive Assessment Scale, Rivermead Behavioral Memory Test, and event-related potential were used to evaluate the cognitive function at baseline, 4- and 8-wk posttreatment, and 1-mo follow-up. There were significant time × group interactions in Montreal Cognitive Assessment Scale (F6,4.20 = 8.38, P < 0.001), event-related potential latent period (F6,294.24 = 5.10, P < 0.001), event-related potential amplitude (F6,1.68 = 23.08, P < 0.001), and Rivermead Behavioral Memory Test (F6,312.61 = 5.42, P < 0.001). Intragroup comparisons showed that Montreal Cognitive Assessment Scale and Rivermead Behavioral Memory Test scores and event-related potential amplitude increased significantly (P < 0.05), and event-related potential latency decreased significantly (P < 0.05) in all groups. Intergroup comparisons showed that the changes of all outcomes in mixed therapy group were greater than those in cognitive training and motor imagery + action observation group (P < 0.05) after treatment. These results suggest that the combination of cognitive training with motor imagery and action observation therapy is an effective treatment on cognitive function in people with vascular cognitive impairment.

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

BackgroundStroke 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.MethodsThe 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.DiscussionThis 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 registrationChinese Clinical Trial Registry ChiCTR1900026656. Registered on 17 October 2019.

A new protocol for assessing action observation and imitation abilities in children with Developmental Coordination Disorder: A feasibility and reliability study

To develop a new protocol for the assessment of action observation (AO) abilities and imitation of meaningful and non-meaningful gestures, to examine its psychometric properties in children with DCD and typically developing (TD) children. For learning manual skills, AO and imitation are considered fundamental abilities. Knowledge about these modalities in children with DCD is scarce and an assessment protocol is lacking. The protocol consists of 2 tests. The AO test consists of two assembly tasks. The imitation test includes 12 meaningful and 20 non-meaningful gestures. Items of both tests are rated on a 4-point scale. Twelve children with DCD (mean age 8y3m, SD, 1.30) and 11 TD children (mean age 8y2m, SD 1.52) were enrolled. For inter-rater reliability, intraclass correlation coefficients (ICC) were calculated for the total score, weighted kappa and percentage agreement for single items. Known group validity was assessed by comparison of DCD and TD group (Wilcoxon rank sum test). For construct validity, the mABC-2 test was used. The protocol was adapted and confirmed by an intra and inter-rater reliability study (new sample of 11 DCD children, mean age 7y5m, SD 1.37). Excellent ICCs were reported for intra and inter-rater reliability for the final protocol. A significant difference between DCD and TD group was found for AO abilities (p<.01), for nonmeaningful gestures (p<.001). A significant correlation was reported between the AO test and the mABC-2 test (r=56;p≤0.0001). No significant correlations were revealed for the imitation tests. The results support the psychometric properties of this protocol. When fully validated, it may contribute to map the deficits in AO abilities and imitation, to evaluate treatment effects of imitation and AO interventions.

Action Observation: A Systematic Review

Abstract Date Presented 03/27/20 With 65% of survivors left with hemiparesis affecting activities of daily living (ADL) performance at six months poststroke, as motor control recovery plateaus at five weeks post stroke, there is a need to identify effective interventions that can begin immediately. This review asked: What is the effectiveness of action observation intervention, as compared to usual rehabilitation therapy, no treatment, or sham treatment for improving upper extremity function or ADL function in stroke survivors with motor impairment? Primary Author and Speaker: Carly Goldberg Additional Authors and Speakers: Dawn Nilsen

Using Action-congruent Language Facilitates the Motor Response during Action Observation: A Combined Transcranial Magnetic Stimulation and Eye-tracking Study.

There is evidence that action observation (AO) and the processing of action-related words are associated with increased activity in cortical motor regions. Research has examined the effects of AO and action verb processing on activity in the motor system independently. The aim of this experiment was to investigate, for the first time, the modulation of corticospinal excitability and visual attention during the concurrent processing of action verbs and AO stimuli. Twenty participants took part in an integrated transcranial magnetic stimulation and eye-tracking protocol. Single-pulse transcranial magnetic stimulation was delivered to the hand representation of the left motor cortex during (i) observation of a static hand, (ii) AO of a hand squeezing a sponge, (iii) AO of the same action with an audio recording of the word "squeeze," and (iv) AO of the same action with an audio recording of the word "green". Motor evoked potentials were recorded from the abductor pollicis brevis and abductor digiti minimi muscles of the right hand. Eye gaze was recorded throughout the four conditions as a proxy for visual attention. Interviews were conducted to discuss participants' preferences and imagery use for each condition. The AO and action verb condition resulted in significantly increased motor evoked potential amplitudes in the abductor pollicis brevis muscle; participants also made significantly more fixations on the sponge and reported wanting to move their hand more in the action verb condition. The inclusion of auditory action verbs, alongside AO stimuli, in movement simulation interventions could have implications for the delivery of AO interventions for motor (re)learning.