Action Observation Training Research Articles

Comparison of the effects of action observation training of community ambulation with different observational views on walking function in patients with chronic stroke: single-subject experimental study

Objectives The aim of this study was to compare the effects of the action-observation training (AOT) of community ambulation with different observational views (first-person versus third-person views) on walking function in patients with chronic stroke. Design A single-subject alternating design. Methods Three ambulatory patients with chronic stroke participated in this study. The AOT of community ambulation, in the first- and third-person views, was alternately applied in the intervention phase. Outcome measures included walking speed (10-m walking test) and peak knee flexion angle (PKFA) during walking. Results When the AOT was performed in the first-person view, walking speeds increased by 0.04, 0.09 and 0.09 m/s, and the PKFA increased by 11.88, 14.67 and 25.29°, for subjects 1, 2 and 3, respectively. After the AOT was performed in the third-person view, the 10MWT speeds increased by 0.04, 0.08 and 0.11 m/s, and PKFAs increased by 13.46, 16.21 and 23.27° for subjects 1, 2 and 3, respectively. However, in the intervention phase, for all the subjects, there were no significant differences in walking speed and the PKFA between the first- and third-person views (p > .05). Conclusions These findings indicate that the AOT of community ambulation may help in clinically improving walking function in patients with chronic stroke, regardless of observational views in the AOT. However, larger studies, with a robust design, are needed to make a definitive judgment on the usefulness of this treatment.

Intra-articular AAV9 α-iduronidase gene therapy in mucopolysaccharidosis type I canine model

The discovery of cortical neurons responsive to both the observation of another individual’s movement and one’s own physical movement has spurred scientists into utilising this interplay for rehabilitation. The idea that humans can quickly transfer motor programmes or refine existing motor strategies through observation has only recently gained interest in the context of gait rehabilitation but may offer significant promise as an adjunctive therapy to routine balance training. This review is the first dedicated to action observation in postural control or gait in healthy individuals and patients. The traditional use of action observation in rehabilitation is that the observer has to carefully watch pre-recorded or physically performed actions and thereafter imitate them. Using this approach, previous studies have shown improved gait after action observation in stroke, Parkinson’s disease and knee or hip replacement patients. In healthy subjects, action observation reduced postural sway from externally induced balance perturbations. Despite this initial evidence, future studies should establish whether patients are instructed to observe the same movement to be trained (i.e., replicate the observed action(s)) or observe a motor error in order to produce postural countermeasures. The best mode of motor transfer from action observation is yet to be fully explored, and may involve observing live motor acts rather than viewing video clips. Given the ease with which action observation training can be applied in the home, it offers a promising, safe and economical approach as an adjunctive therapy to routine balance training.

The Role of Movement Representation Techniques in the Motor Learning Process: A Neurophysiological Hypothesis and a Narrative Review.

We present a neurophysiological hypothesis for the role of motor imagery (MI) and action observation (AO) training in the motor learning process. The effects of movement representation in the brain and those of the cortical–subcortical networks related to planning, executing, adjusting, and automating real movements share a similar neurophysiological activity. Coupled with the influence of certain variables related to the movement representation process, this neurophysiological activity is a key component of the present hypothesis. These variables can be classified into four domains: physical, cognitive–evaluative, motivational–emotional, and direct-modulation. The neurophysiological activity underlying the creation and consolidation of mnemonic representations of motor gestures as a prerequisite to motor learning might differ between AO and MI. Together with variations in cognitive loads, these differences might explain the differing results in motor learning. The mirror neuron system appears to function more efficiently through AO training than MI, and AO is less demanding in terms of cognitive load than MI. AO might be less susceptible to the influence of variables related to movement representation.

Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response.

Introduction:Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatment response.Methods:A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months) participated in a 9-day camp wearing a splint for 6 h/day and were allocated to the CIMT + AOT (n = 22) and the CIMT + placebo group (n = 22). The CIMT + AOT group received 15 h of AOT (i.e. video-observation) and executed the observed tasks, whilst the CIMT + AOT group watched videos free of biological motion and executed the same tasks. The primary outcome measure was bimanual performance. Secondary outcomes included measures of body function and activity level assessed before (T1), after the intervention (T2), and at 6 months follow-up (T3). Influencing factors included behavioural and neurological characteristics.Results:Although no between-groups differences were found (p > 0.05; η2 = 0–16), the addition of AOT led to higher gains in children with initially poorer bimanual performance (p = 0.02; η2 = 0.14). Both groups improved in all outcome measures after the intervention and retained the gains at follow up (p < 0.01; η2 = 0.02–0.71). Poor sensory function resulted in larger improvements in the total group (p = 0.03; η2 = 0.25) and high amounts of mirror movements tended to result in a better response to the additional AOT training (p = 0.06; η2 = 0.18). Improvements were similar irrespective of the type of brain lesion or corticospinal tract wiring pattern.Conclusions:Adding AOT to CIMT, resulted in a better outcome for children with poor motor function and high amounts of mirror movements. CIMT with or without AOT seems to be more beneficial for children with poor sensory function.Trial registration:Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov identifier: NCT03256357).

Effects of Otago exercise combined with action observation training on balance and gait in the old people.

This study aimed to investigate the effects of Otago exercise combined with action observation (AO) training on the balance, and gait in the old people to prevent falls in the community. A total of 30 old women participated and randomly assigned into three groups: AO plus Otago (n=10), Otago (n=10), or control (n=10). The AO plus Otago and Otago groups performed 50 min of strength training and balance exercises from the Otago Exercise Program 3 times a week for 12 weeks. The AO plus Otago group received an additional 20 min of training 3 times a week. We used the electronic muscle dynamometer to changes in strength, Timed Up and Go (TUG) test to evaluate dynamic balance, and the short version of the Falls Efficacy Scale-International was used to evaluate the fear of falls, and GAITRite was used to evaluate changes in the spatiotemporal parameters of walking. The muscle strength significantly increased in the AO plus Otago and Otago groups compared to the strength before training. The TUG test showed a significant improvement in the dynamic balance in both intervention groups. A significant increase was observed in the walking speed, cadence, step length, and stride length in both intervention groups. We also noted a significant change in the efficacy measures for falls. It is expected that Otago exercise combined with AO training will be used as an intervention method in hospital treatment programs and the old people facilities for preventing falls in the old people.

Effects of Action Observation Training with 1 Hz Low Frequency Repeated Transcranial Magnetic Stimulation on Cerebral Cortex Activity and Hand Function in Patients with Ideomotor Apraxia after Stroke

The aim of this study was to investigate the effects of action observation training with low frequency repeated transcranial magnetic stimulation (rTMS) on cerebral cortex activity and hand function in patients with ideomotor apraxia after Stroke. Fourteen patients were randomly divided into two groups which in action observation training (AOT) with 1 Hz low-frequency rTMS and AOT without rTMS. Motor evoked potential (MEP) amplitude and latency were examined by TMS for cerebral cortex activity and hand function was evaluated by manual function test (MFT). As a result, there was a significant difference in MEP amplitude in group, but only AOT with rTMS group was a significant difference in MEP latency and MFT. In addition, there was a significant difference of MEP amplitude, latency and MFT between groups. These results suggest that application of AOT and rTMS can have a positive effect on the recovery of hand function in ideomotor apraxia after patients.

The Effects of the Otago Exercise Combined with Action Observation Training on Brain Activity of the Elderly

The Effects of the Otago Exercise Combined with Action Observation Training on Brain Activity of the Elderly

Feasibility of Action Observation Training [AOT] in Infants After Unilateral Brain Lesion

Feasibility of Action Observation Training [AOT] in Infants After Unilateral Brain Lesion

Action observation training for rehabilitation in brain injuries: a systematic review and meta-analysis

BackgroundTo systematically review and analyse the effects of Action Observation Training on adults and children with brain damage.MethodsSeven electronic databases (Cochrane, EBSCO, Embase, Eric, PubMed, Scopus and Web of Science) were searched up to 16 September 2018 to select Randomized Controlled Trials focused on adults and children with brain damage that included AOT training on upper and/or lower limb carried out for at least 1 week. Identification of studies and data extraction was conducted with two reviewers working independently. Oxford Centre for Evidence-based Medicine (March2009) – Levels of Evidence and Physiotherapy Evidence Database scale were used to grade studies. The data collected from the articles were analysed using software R, version 3.4.3. Hedge’s g values were calculated and effect size estimates were pooled across studies. Separate meta-analyses were carried out for each ICF domain (i.e. body function and activity) for upper and lower limb.ResultsOut of the 210 records identified after removing duplicates, 22 were selected for systematic review and 19 were included in the meta-analysis. Thirteen studies included in the meta-analysis focused on upper limb rehabilitation (4 in children and 9 in adults) and 6 on lower limb rehabilitation (only studies in adults). A total of 626 patients were included in the meta-analysis. An overall statistically significant effect size was found for upper limb body function (0.44, 95% CI: [0.24, 0.64], p < 0.001) and upper limb activity domain (0.47, 95% CI: [0.30, 0.64], p < 0.001). For lower limb, only the activity domain was analysed, revealing a statistically significant overall effect size (0.56, 95% CI: [0.28, 0.84], p < 0.001).ConclusionsAction Observation Training (AOT) is an innovative rehabilitation tool for individuals with brain damage, which shows promising results in improving the activity domain for upper and lower limbs, and also the body function domain for the upper limb. However, the examined studies lack uniformity and further well-designed, larger controlled trials are necessary to determine the most suitable type of AOT particularly in children.Systematic review registrationCRD42019119600.

Action Observation Training in Patients With Chronic Low Back Pain

Action Observation Training in Patients With Chronic Low Back Pain

Action observation training promotes motor improvement and modulates functional network dynamic connectivity in multiple sclerosis

We investigated modifications of resting state dynamic functional network connectivity (dFNC) following a 2-week action observation training (AOT) in 46 right-handed healthy controls (HC) and 41 patients with multiple sclerosis (pwMS) and dominant-hand motor impairment, who were randomized to AOT or control (C) training. PwMS had decreased baseline dFNC versus HC. After training, MS groups improved in right upper limb functions, mainly in AOT, and showed dFNC increase (larger in MS-AOT vs MS-C) in sensorimotor and cognitive networks (p range, ⩽0.001–0.01). Both HC groups showed decreased dFNC over time (p range, ⩽0.001–0.01). Clinical improvements following interventions correlated with sensorimotor and cognitive dFNC changes, suggesting their possible role in motor recovery.

Effects of Motor Imagery and Action Observation on Lumbo-pelvic Motor Control, Trunk Muscles Strength and Level of Perceived Fatigue: A Randomized Controlled Trial

ABSTRACTPurpose: The aim of the study was to evaluate the effects of motor imagery (MI) and action observation (AO) combined with a motor control exercises program for the lumbopelvic region. Method: Forty-five asymptomatic individuals were randomized into three groups: MI (n = 15), AO (n = 15) or control group (CG) (n = 15). The outcome measures included lumbopelvic motor control measured with a stabilizer pressure biofeedback, trunk muscle strength using a dynamometer and the perceived fatigue using a visual analogue scale. Participants were assessed at pre-intervention, at first week of intervention (mid) and post-intervention. Results: Regarding lumbopelvic motor control, we observed significant within-group differences between pre- and the mid and post-intervention assessment in AO group (p < .001, d > 0.80). MI and CG groups showed significant differences between pre- and post-intervention assessment (p < .05, d > 0.80). Regarding the direct comparison in the ΔMid-Pre differences between groups, only the AO group was superior to the CG with a large effect size (d > 0.80). Regarding trunk muscle strength, significant within-group differences between pre- and post-intervention assessments were observed in AO (p < .001, d = —1.25) and MI (p < .05, d = —1.00) groups. In relation to the perceived fatigue, statistically significant within-group differences were found in all groups (p < .05, d > 0.60). Conclusion: AO training caused faster changes in lumbopelvic motor control compared with the CG group. The AO strategy could be used as a guideline for teaching lumbopelvic motor control exercises.

The effects of observation learning combined motor imagery and action observation on the basketball skills

Purpose In general, motor imagery and action observation have been distinguished from each other. Recently, several studies demonstrated that combined approach to motor imagery and action observation can be more effective in motor learning. The present study examined the effects of observation learning combined motor imagery and action observation during acquisition basketball shooting skills. Methods We divided with control group, action observation group and observation learning group combined mental image and action observation in the three middle school. Action observation group provided the action observation program, and observation learning group was performed observation learning combined mental image and action observation training. All groups were perform basic basketball skills. Experimental intervention was performed for 10 weeks, and data analysis was performed 3 groups × 2 time repeated ANOVA. Results The results indicated that all group were improve after intervention, and subjects who participated in combined mental image and action observation was significant in the interaction effect on the front shoot. Moreover, the interaction effect on the motor imagery ability was significant. Conclusions These findings suggest that the use of observation learning combined mental image and action observation strategy potentially optimizes motor skills performance and motor image ability by incorporating motor imagery, especially when observing movements with intent to imitate.

Effects of Action Observation Training in Gait Speed of Stroke Patients: A Case Series

Stroke is considered as a primary cause of disability and results to problems in activities of daily living. Action Observation Training (AOT) is an emerging cost-effective physical therapy intervention (PT) which involves facilitation of mirror neurons through viewing of video clips of a healthy individual performing an activity similar to that of the desired task. This intends to describe the effects of AOT used in conjunction with conventional PT interventions in gait speed of stroke patients.

Mental practice in isolation improves cervical joint position sense in patients with chronic neck pain: a randomized single-blind placebo trial.

ObjectiveThe main objective of this trial was to assess whether action observation (AO) training and motor imagery (MI) produced changes in the cervical joint position sense (CJPS) both at the end of the intervention and 10 min postintervention compared with a placebo intervention in patients with nonspecific chronic neck pain (NSCNP).MethodsA single-blind placebo clinical trial was designed. A total of 30 patients with NSCNP were randomly assigned to the AO group, MI group or placebo observation (PO) group. CJPS in flexion, extension and rotation movements in both planes were the main variables.ResultsThe results obtained in the vertical plane showed that the AO group obtained greater improvements than the PO group in the CJPS in terms of cervical extension movement both at the end of the intervention and 10 min postintervention (p = .001, d = 1.81 and p = .004, d = 1.74, respectively), and also in cervical flexion movement, although only at 10 min after the intervention (p = .035, d = 0.72). In addition, the AO group obtained greater improvements than the MI group in the CJPS only at the end of the intervention in cervical extension movement (p = .041, d = 1.17). Regarding the left rotation cervical movement, both the MI and AO groups were superior to the PO group in both planes at the end of the intervention (p < .05, d > 0.80).ConclusionsAlthough both AO and MI could be a useful strategy for CJPS improvement, the AO group showed the strongest results. The therapeutic potential of the application of mental practice in a clinical context in the early stages of rehabilitation of NSCNP should be considered.

Backward walking observational training improves gait ability in patients with chronic stroke: randomised controlled pilot study.

Backward walking has a positive effect on gait ability. Action observational training is an effective treatment method for stroke neurological disorders. This randomised comparator-controlled pilot study aimed to evaluate the feasibility of backward walking observational training on the gait ability of chronic stroke patients. Fourteen chronic stroke participants were randomly allocated to the experimental group (backward walking observation; n = 7) and control group (landscape observation; n = 7). Both groups performed conventional therapy 5 days/week; then the backward walking observation and landscape observation + backward walking training groups performed the observational training 3 days/week for 4 weeks. The primary outcome was measured dynamic gait index, 10-m walking test, and timed up and go test time. Both groups showed significant increases in dynamic gait index, 10-m walking test, and timed up and go test time. The experimental group showed more significant improvements in dynamic gait index (P = 0.04, η = 0.336), 10-m walking test (P = 0.04, η = 0.306), and timed up and go test time (P = 0.03, η = 0.334) than the control group. This pilot study demonstrated that conventional therapy with backward walking observational training improves gait ability. Our findings suggest that observing an action may have a positive effect on chronic stroke patients.Trial Registration Clinical Trials: KCT0003098.

Improved dual-task performance during turning after a single session of action observation training in Parkinson's disease patients

Improved dual-task performance during turning after a single session of action observation training in Parkinson's disease patients

The effects of action observation training on improving upper limb motor functions in people with stroke: A systematic review and meta-analysis.

Background and objectiveAction observation training (AOT) has been used as a new intervention for improving upper limb motor functions in people with stroke. This systematic review and meta-analysis aims to investigate the effects of AOT on improving upper limb motor functions in people with stroke.MethodsWe searched ten electronic databases to identify randomized controlled trials (RCTs) about the effects of AOT on upper limb motor functions in stroke survivors. Methodological quality of included studies was assessed by the Risk of Bias Tool in the Cochrane Handbook for Systematic Reviews of Interventions. A random-effects meta-analysis was performed by pooling the standardized mean difference (SMD) of upper limb motor outcomes.ResultsSeven studies of 276 participants with stroke were included. Meta-analysis showed a significant effect favoring AOT on improving upper limb motor functions in patients with stroke [SMD = 0.35, 95% confidence interval [CI], 0.10 to 0.61, I2 = 10.14%, p = 0.007].ConclusionsAOT appears to be an effective intervention for improving the upper limb motor functions in people after stroke. Further studies need to investigate the neural mechanism underlying the effects of AOT.

Effect of Brain Training Through Visual Mirror Feedback, Action Observation Training and Motor Imagery on Orofacial Sensorimotor Variables in Asymptomatic Subjects: A Single-blind Randomized Controlled Trial.

Effect of Brain Training Through Visual Mirror Feedback, Action Observation Training and Motor Imagery on Orofacial Sensorimotor Variables in Asymptomatic Subjects: A Single-blind Randomized Controlled Trial.

Effects of motor imagery combined with action observation training on the lateral specificity of muscle strength in healthy subjects.

Unilateral training of both lateral limbs increases unilateral muscle strength, whereas bilateral training increases bilateral muscle strength, a phenomenon known as lateral specificity in resistance training. Although motor imagery (MI) combined with action observation (AO) (i.e., MI + AO) training increases muscle strength, it is not completely understood whether such training increases the lateral specificity of muscle strength in a way resistance training does. To investigate whether MI + AO induces lateral specificity of muscle strength increase, 18 healthy subjects were divided into groups: MI + AO and the control groups. The control group watched a movie of natural sceneries for ten minutes per day five times a week for three weeks, whereas the MI + AO group imagined bilateral shoulder flexion while watching a movie of athletes performing bilateral shoulder flexion with barbells or dumbbells, with the same time schedule. The MI + AO group alone showed a significant increase in bilateral shoulder strength at three weeks after the intervention compared with the baseline. Unilateral shoulder strength was not significantly altered. These results suggest that MI + AO training increases muscle strength, providing evidence that similar to resistance training, lateral specificity also exists in MI + AO training.