Effects Of Action Observation Research Articles

Quantitative EEG for the Monitoring of Walking Recovery in Chronic Stroke Patients Receiving Action Observation Training

The current study aimed to evaluate the effects of action observation on the walking ability and oscillatory brain activity of chronic stroke patients. Fourteen chronic stroke patients were allocated randomly to the action observation (AO) or sham observation (SO) groups. Both groups received 12 sessions of intervention. Each session composed of 12 min of observational training, which depicted exercises for the experimental group but nature pictures for the sham group and 40 min of occupational therapy, which was the same for the both groups. Walking ability was assessed by a motion analysis system and brain activity was monitored using quantitative electroencephalography (QEEG) before and after the intervention. Brain asymmetry at alpha frequency, the percentage of stance phase, and step length showed significant changes in the AO group. Only the change in global alpha power was significantly correlated with the change in velocity after the intervention in AO group. Despite more improvements in walking and brain activity of patients in the AO group, our study failed to show significant correlations between the brain activity changes and functional improvements after the intervention, which might be mainly due to the small sample size in our study. Trial registration: IRCT20181014041333N1

The effect of action observation and motor imagery on jumping and perceived performance.

Action observation (AO) and motor imagery (MI) are cognitive processes that involve mentally rehearsing and simulating movements without physically performing them. However, the need for the evidence to support influence of imagery on performance is increasing. This study aims to investigate the impact of combining motor imagery with action observation on athletes' performance and performance perception. Using a pre-test post-test design with a factorial setup, participants were randomly assigned to experimental and control groups. A pre-research power analysis determined the sample size, resulting in 21 voluntary participants (10 male). Opto Jump device recorded drop jump performance measurements, while participants predicted their performance post-motor imagery and action observation practices. The experimental group underwent an 8-week AOMI intervention program, involving 24-minute motor imagery sessions during video observation thrice weekly. Post-test measurements were taken after the intervention. Results indicated no significant performance increase in the experimental group post-intervention, yet the group showed enhanced performance estimation following the video observation, but not in motor imagery condition. Conversely, this improvement was absent in the control group. Although AOMI intervention didn't enhance physical performance, it has positively affected athletes' perception toward their performance. The findings are discussed in relation to existing literature.

In Chronic Stroke, The Effect Of Action Observation And An Accelerated Skill Acquisition Program

In Chronic Stroke, The Effect Of Action Observation And An Accelerated Skill Acquisition Program

The effect of action observation combined with high-definition transcranial direct current stimulation on motor performance in healthy adults: A randomized controlled trial.

Action observation (AO) can improve motor performance in humans, probably via the human mirror neuron system. In addition, there is some evidence that transcranial direct current stimulation (tDCS) can improve motor performance. However, it is yet to be determined whether AO combined with tDCS has an enhanced effect on motor performance. We investigated the effect of AO combined with high-definition tDCS (HD-tDCS) targeting the inferior parietal lobe (IPL) and inferior frontal gyrus (IFG), the main aggregates of the human mirror neuron system, on motor performance in healthy adults and compared the immediate vs. 24-h retention test effects (anodal electrodes were placed over these regions of interest). Sixty participants were randomly divided into three groups that received one of the following single-session interventions: (1) observation of a video clip that presented reaching movement sequences toward five lighted units + active HD-tDCS stimulation (AO + active HD-tDCS group); (2) observation of a video clip that presented the same reaching movement sequences + sham HD-tDCS stimulation (AO + sham HD-tDCS group); and (3) observation of a video clip that presented neutral movie while receiving sham stimulation (NM + sham HD-tDCS group). Subjects' reaching performance was tested before and immediately after each intervention and following 24 h. Subjects performed reaching movements toward units that were activated in the same order as the observed sequence during pretest, posttest, and retest. Occasionally, the sequence order was changed by beginning the sequence unexpectedly with a different activated unit. Outcome measures included mean Reaching Time and difference between the Reaching Time of the unexpected and expected reaching movements (Delta). In the posttest and retest, Reaching Time and Delta improved in the AO + sham HD-tDCS group compared to the NM + HD-sham tDCS group. In addition, at posttest, Delta improved in the AO + active HD-tDCS group compared to the NM + sham HD-tDCS group. It appears that combining a montage of active HD-tDCS, which targets the IPL and IFG, with AO interferes with the positive effects of AO alone on the performance of reaching movement sequences.

The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis

AMA Conte D, Miani J, Pinzini C. The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis. Advances in Rehabilitation / Postępy Rehabilitacji. 2023. doi:10.5114/areh.2023.127924. APA Conte, D., Miani, J., & Pinzini, C. (2023). The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis. Advances in Rehabilitation / Postępy Rehabilitacji. https://doi.org/10.5114/areh.2023.127924 Chicago Conte, Daniele, Jarno Miani, and Chiara Pinzini. 2023. "The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis". Advances in Rehabilitation / Postępy Rehabilitacji. doi:10.5114/areh.2023.127924. Harvard Conte, D., Miani, J., and Pinzini, C. (2023). The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis. Advances in Rehabilitation / Postępy Rehabilitacji. https://doi.org/10.5114/areh.2023.127924 MLA Conte, Daniele et al. "The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis." Advances in Rehabilitation / Postępy Rehabilitacji, 2023. doi:10.5114/areh.2023.127924. Vancouver Conte D, Miani J, Pinzini C. The effects of action observation in the lower limb landing biomechanics: a systematic review and meta-analysis. Advances in Rehabilitation / Postępy Rehabilitacji. 2023. doi:10.5114/areh.2023.127924.

The value of corticospinal excitability and intracortical inhibition in predicting motor skill improvement driven by action observation

The observation of other's actions represents an essential element for the acquisition of motor skills. While action observation is known to induce changes in the excitability of the motor cortices, whether such modulations may explain the amount of motor improvement driven by action observation training (AOT) remains to be addressed. Using transcranial magnetic stimulation (TMS), we first assessed in 41 volunteers the effect of action observation on corticospinal excitability, intracortical inhibition, and transcallosal inhibition. Subsequently, half of the participants (AOT-group) were asked to observe and then execute a right-hand dexterity task, while the controls had to observe a no-action video before practicing the same task. AOT participants showed greater performance improvement relative to controls. More importantly, the amount of improvement in the AOT group was predicted by the amplitude of corticospinal modulation during action observation and, even more, by the amount of intracortical inhibition induced by action observation. These relations were specific for the AOT group, while the same patterns were not found in controls. Taken together, our findings demonstrate that the efficacy of AOT in promoting motor learning is rooted in the capacity of action observation to modulate the trainee's motor system excitability, especially its intracortical inhibition. Our study not only enriches the picture of the neurophysiological effects induced by action observation onto the observer's motor excitability, but linking them to the efficacy of AOT, it also paves the way for the development of models predicting the outcome of training procedures based on the observation of other's actions.

The Effect of Action Observation Combined with Motor Imagery Training on Upper Extremity Function and Corticospinal Excitability in Stroke Patients: A Randomized Controlled Trial.

This study aimed to investigate the effect of motor imagery (MI) intervention with action observation (AO) on upper extremity function and corticospinal activation in stroke patients. MI and AO are two forms of motion simulation that activate the motor system without physical activity. There are many studies that show the effect of AO and MI alone, but there are few studies in parallel. This study was conducted on 45 patients who were divided into an experimental group (n = 22) and a control group (n = 23) using a computer randomization program. The experimental group conducted AO with MI, and the control group only AO. All participants received interventions for twenty-five minutes per session, five times a week, for eight weeks. For the pre- and post-evaluation of all participants, motor evoked potential (MEP) amplitude was measured to compare corticospinal activation, and Fugl-Meyer Assessment Upper Extremity (FMA UE), Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL) were evaluated for changes in upper extremity function. In comparing the amount of change before and after the intervention, a significant change was observed in the experimental group’s MEP amplitude. In the comparison between groups after the intervention and the amount of change before and after the intervention, the experimental group showed significant changes in FMA UE and MAL Amount of Use (MAL AOU) items. As a result of this study, AO with MI is effective in enhancing upper extremity function and increasing cortical spinal cord activation in patients with severe stroke with limited movement.

The Reaching Phase of Feeding and Self-Care Actions Optimizes Action Observation Effects in Chronic Stroke Subjects

Background The Action Observation Therapy (AOT) is a well-established post-stroke rehabilitation treatment based on the theoretical framework of the Mirror Neuron System (MNS) activation. However, AOT protocols are still heterogeneous in terms of video contents of observed actions. Objective The aim of this study was to analyze electroencephalographic (EEG) recordings in stroke patients during the observation of different videos of task-specific upper limb movements, and to define which category of actions can elicit a stronger cortical activation in the observer’s brain. Methods Signals were analyzed from 19 chronic stroke subjects observing customized videos that represented 3 different categories of upper limb actions: Finalized Actions, Non-Finalized Actions, and Control Videos. The Event-Related Desynchronization in the µ and β bands was chosen to identify the involvement of the cerebral cortex: the area of the normalized power spectral density was calculated for each category and, deepening, for the reaching and completion sub-phases of Finalized Actions. For descriptive purposes, the time course of averaged signal power was described. The Kruskal–Wallis test (P < .05) was applied. Results The analysis showed a greater desynchronization when subjects observed Finalized Actions with respect to Non-Finalized in all recorded areas; Control videos provoked a synchronization in the same areas and frequency bands. The reaching phase of feeding and self-care actions evoked a greater suppression both in µ and β bands. Conclusions The observation of finalized arm movements seems to elicit the strongest activation of the MNS in chronic stroke patients. This finding may help the clinicians to design future AOT-based stroke rehabilitation protocols. Clinical Trial Registration: Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT04047134.

Action Observation and Motor Imagery administered the day before surgery enhance functional recovery in patients after total hip arthroplasty: A randomized controlled trial

Objective To investigate the effects of Action Observation and Motor Imagery administered the day before surgery on functional recovery in patients after total hip arthroplasty. Design Randomised controlled trial. Setting Humanitas Clinical and Research Center, Milan, Italy Participants Eighty inpatients with end-stage hip osteoarthritis undergoing total hip arthroplasty. Interventions All patients followed a standardized postoperative rehabilitation program. Experimental group (AO + MI) performed two 12-minute Action Observation and Motor Imagery sessions on the preoperative day, whereas control group underwent usual care consisting of education without any additional preoperative activity. Outcome measures A blinded physiotherapist assessed participants for functional mobility (Timed Up and Go – TUG) (primary outcome), maximum walking speed (10-Meter Walk Test – 10MWT), pain (Numeric Pain Rating Scale – NPRS) and fear of movement (Tampa Scale of Kinesiophobia – TSK) the day before and at four days after surgery. Results No between-group differences were found at baseline. Although TUG and 10MWT worsened in both groups (p < 0.001), better TUG was found for AO + MI group at four days (mean difference −5.8 s, 95% confidence interval from −11.3 to −0.3 s, p = 0.039). NPRS (p < 0.001) and TSK (p = 0.036 for AO + MI group, p = 0.003 for control group) improved after surgery without between-group differences. Conclusions Patients undergoing Action Observation and Motor Imagery on the day before surgery showed less functional decline than control group in the first days after total hip arthroplasty. This intervention may contribute to a safer discharge with higher functional abilities in patients hospitalized for total hip arthroplasty.

The effect of action observation training on gait and balance of patients with neurological and musculoskeletal disorders: A systematic review

Background Various treatment approaches are being applied for recovery of gait after different medical conditions. Action observation is a new motor learning approach, which is considered as a complementary training to the conventional rehabilitation programs such as occupational therapy for this purpose. Objective To find out which patients benefit more from action observation training. Methods Electronic databases, including Scopus, PubMed, Web of Science, Science Direct, and PEDro were searched. Prospective studies published in peer-reviewed journals with full text available in English, which investigated the effect of action observation on gait and balance of patients with neurologic or musculoskeletal disorders, were included. The methodological quality of the studies was assessed by the Downs and Black checklist, and the information was presented based on the PICO style. Results Nineteen studies recruiting post-orthopedic patients (4 studies), patients with stroke (11 studies), and Parkinson’s disease (4 studies) fulfilled the eligibility criteria. Quality scores ranged from 51.85% to 81.48%. Balance and walking ability were the most reported primary outcomes. Conclusion Patients in the chronic phase of stroke might benefit more from action observation training plus occupational therapy in different aspects of gait than orthopedic patients and those with Parkinson’s disease.

Effects of action observation and motor imagery of walking on the corticospinal and spinal motoneuron excitability and motor imagery ability in healthy participants.

Action observation (AO) and motor imagery (MI) are used for the rehabilitation of patients who face difficulty walking. Rehabilitation involving AO, MI, and AO combined with MI (AO+MI) facilitates gait recovery after neurological disorders. However, the mechanism by which it positively affects gait function is unclear. We previously examined the neural mechanisms underlying AO and MI of walking, focusing on AO+MI and corticospinal and spinal motor neuron excitability, which play important roles in gait function. Herein, we investigated the effects of a short intervention using AO+MI of walking on the corticospinal and spinal motor neuron excitability and MI ability of participants. Twelve healthy individuals participated in this study, which consisted of a 20 min intervention. Before the experiment, we measured MI ability using the Vividness of Movement Imagery Questionnaire-2 (VMIQ-2). We used motor evoked potential and F-wave measurements to evaluate the corticospinal and spinal motor neuron excitability at rest, pre-intervention, 0 min, and 15 min post-intervention. We also measured corticospinal excitability during MI of walking and the participant’s ability to perform MI using a visual analog scale (VAS). There were no significant changes in corticospinal and spinal motor neuron excitability during and after the intervention using AO+MI (p>0.05). The intervention temporarily increased VAS scores, thus indicating clearer MI (p<0.05); however, it did not influence corticospinal excitability during MI of walking (p>0.05). Furthermore, there was no significant correlation between the VMIQ-2 and VAS scores and changes in corticospinal and spinal motor neuron excitability. Therefore, one short intervention using AO+MI increased MI ability in healthy individuals; however, it was insufficient to induce plastic changes at the cortical and spinal levels. Moreover, the effects of intervention using AO+MI were not associated with MI ability. Our findings provide information about intervention using AO+MI in healthy individuals and might be helpful in planning neurorehabilitation strategies.

Action observation facilitates anticipatory control of grasp for object mass but not weight distribution

Action observation has been shown to facilitate the performance of the observer and is being increasingly used as a rehabilitation tool following neurological damage. During object manipulation, visual observation of performance is suggested to enable the updating of the sensorimotor representations of object properties. Here, through 3 experiments, we examine the effect of action observation of a novel object on the updating of object mass and weight distribution for bimanual manipulation. For each experiment, naïve participants were allocated into pairs and assigned as the “performer” or “observer”. For experiments 1 and 2, observers sat opposite the performers. For experiment 3, observers stood behind the performer. The pairs observed and lifted either i) a light or heavy box in experiment 1, or ii) a box with a left or right uneven center of mass in experiments 2 and 3. Our results showed that action observation facilitated the updating of object mass information but not information about weight distribution. Specifically, observers of the heavy box subsequently applied larger forces and force rates in accord with the mass of the box. In contrast, both performers and observers of the uneven box had large peak rolls. We suggest that this shows the robustness of observation in facilitating an understanding of object mass while highlighting the complexity of manipulating an object with uneven weight distribution.

Effects of Action Observation with Real-Time Feedback Treadmill Training on Gait and Lower Extremity Joint Angle in Patients with Stroke: A Pilot Study

Effects of Action Observation with Real-Time Feedback Treadmill Training on Gait and Lower Extremity Joint Angle in Patients with Stroke: A Pilot Study

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.

The effect of action observation on aesthetic preference of Chinese calligraphy: An fMRI study.

IntroductionThere is some evidence suggesting that movement perception has an effect on aesthetic experience. However, the neural mechanisms underlying the observation of creators’ creative action (the process that calligraphers create calligraphy) remain unclear.MethodsIn this study, participants were scanned with fMRI while performing aesthetic judgments on Chinese calligraphy images with/without action observation.ResultsBehavioral results showed that both the work by the expert and novice with action observation were rated significantly higher on aesthetic preference than those without action observation. Imaging results showed that brain regions associated with perceptual, cognitive, and emotional processing were commonly activated by calligraphy images with/without action observation. However, compared with no action observation, aesthetic judgments of calligraphy images with action observation elicited stronger activation in the anterior cingulate cortex and the bilateral insula. Meanwhile, the superior parietal lobe which is associated with relevant inner action imitation, was also activated when observing the creator's action.ConclusionsBrain activation in the superior parietal lobe, anterior cingulate cortex, and the bilateral insula indicated that observing the creative action of the creators contributed to the aesthetic experience of the observer.

The Effects of Action Observation with Functional Electrical Stimulation on Corticomuscular Coherence

Objective: To investigate the action observation effects of functional electrical stimulation (FES) on the communication between motor cortex and muscle through corticomuscular coherence (CMC) analysis. Methods: Electroencephalogram (EEG) and electromyogram (EMG) of 27 healthy, nonathlete subjects were measured during action observation, FES, and action observation with FES, which lasted for 7sper session for 10 times. All trials were repeated for 30 times. Simultaneously measured EEG raw data and rectified EMG signals were used to calculate CMC. Only confidence limit values above 0.0306 were used for analysis. CMC was divided into three frequency domains, andthe grand average coherence and peak coherence were computed. Repeated ANOVA was performed to analyze the coherence value difference for each condition’s frequency band. Results: CMC showed significant differences in peak coherence and average coherence between the conditions (p<0.05). Action observation application with FES in all frequency band showed the highest peak and average coherence value. Conclusions: The results of this study are assumed to be the combination of increased eccentric information transfer from the sensory-motor cortex by action observation and an increased in concentric sensory input from the peripheral by the FES, suggesting that these are reflecting the sensorimotor integration process.

Virtual reality-based action observation facilitates the acquisition of body-powered prosthetic control skills

BackgroundRegular body-powered (BP) prosthesis training facilitates the acquisition of skills through repeated practice but requires adequate time and motivation. Therefore, auxiliary tools such as indirect training may improve the training experience and speed of skill acquisition. In this study, we examined the effects of action observation (AO) using virtual reality (VR) as an auxiliary tool. We used two modalities during AO: three-dimensional (3D) VR and two-dimensional (2D) computer tablet devices (Tablet). Each modality was tested from first- and third-person perspectives.MethodsWe studied 40 healthy right-handed participants wearing a BP prosthesis simulator on their non-dominant hands. The participants were divided into five groups based on combinations of the different modalities and perspectives: first-person perspective on VR (VR1), third-person perspective on VR (VR3), first-person perspective on a tablet (Tablet1), third-person perspective on a tablet (Tablet3), and a control group (Control). The intervention groups observed and imitated the video image of prosthesis operation for 10 min in each of two sessions. We evaluated the level of immersion during AO using the visual analogue scale. Prosthetic control skills were evaluated using the Box and Block Test (BBT) and a bowknot task (BKT).ResultsIn the BBT, there were no significant differences in the amount of change in the skills between the five groups. In contrast, the relative changes in the BKT prosthetic control skills in VR1 (p < 0.001, d = 3.09) and VR3 (p < 0.001, d = 2.16) were significantly higher than those in the control group. Additionally, the immersion scores of VR1 (p < 0.05, d = 1.45) and VR3 (p < 0.05, d = 1.18) were higher than those of Tablet3. There was a significant negative correlation between the immersion scores and the relative change in the BKT scores (Spearman’s rs = − 0.47, p < 0.01).ConclusionsUsing the BKT of bilateral manual dexterity, VR-based AO significantly improved short-term prosthetic control acquisition. Additionally, it appeared that the higher the immersion score was, the shorter the execution time of the BKT task. Our findings suggest that VR-based AO training may be effective in acquiring bilateral BP prosthetic control, which requires more 3D-based operation.

The Effects of Instruction Manipulation on Motor Performance Following Action Observation.

The effects of action observation (AO) on motor performance can be modulated by instruction. The effects of two top-down aspects of the instruction on motor performance have not been fully resolved: those related to attention to the observed task and the incorporation of motor imagery (MI) during AO. In addition, the immediate vs. 24-h retention test effects of those instruction’s aspects are yet to be elucidated. Forty-eight healthy subjects were randomly instructed to: (1) observe reaching movement (RM) sequences toward five lighted units with the intention of reproducing the same sequence as fast and as accurate as possible (Intentional + Attentional group; AO+At); (2) observe the RMs sequence with the intention of reproducing the same sequence as fast and as accurate as possible and simultaneously to the observation to imagine performing the RMs (Intentional + attentional + MI group; AO+At+MI); and (3) observe the RMs sequence (Passive AO group). Subjects’ performance was tested before and immediately after the AO and retested after 24 h. During each of the pretest, posttest, and retest, the subject performed RMs toward the units that were activated in the same order as the observed sequence. Occasionally, the sequence order was changed by beginning the sequence with a different activated unit. The outcome measures were: averaged response time of the RMs during the sequences, difference between the response time of the unexpected and expected RMs and percent of failures to reach the target within 1 s. The averaged response time and the difference between the response time of the unexpected and expected RMs were improved in all groups at posttest compared to pretest, regardless of instruction. Averaged response time was improved in the retest compared to the posttest only in the Passive AO group. The percent of failures across groups was higher in pretest compared to retest. Our findings suggest that manipulating top-down aspects of instruction by adding attention and MI to AO in an RM sequence task does not improve subsequent performance more than passive observation. Off-line learning of the sequence in the retention test was improved in comparison to posttest following passive observation only.

Effect of brain training through visual mirror feedback, action observation and motor imagery on orofacial sensorimotor variables: A single‐blind randomized controlled trial

The main objective was to evaluate the effects of action observation (AO), visual mirror feedback (VMF) and motor imagery (MI), combined with an oro-facial exercise programme, on sensorimotor variables in asymptomatic participants. We designed a randomised, single-blind, controlled trial that included 52 asymptomatic participants who were randomly assigned to 4 groups, 13 to each of the VMF, MI and AO groups and 13 to the control group (CG), which only performed the exercise programme. The primary outcomes were pain pressure sensitivity and tongue muscle strength. The secondary outcomes were maximum mouth opening, tongue length and the ability to generate mental motor images. Each group underwent a 3-session intervention using their respective exercise. Measurements were performed before starting the intervention and after each of the 3 sessions (pre, mid1, mid2 and post). ANOVA revealed significant changes in PPTs in the masseter muscle region in the MI and AO groups in the pre-post and mid1-post changes. ANOVA revealed significant differences in tongue muscle strength in the anterior direction only in the AO group in the pre-mid2 and pre-post changes. AO and MI, in conjunction with exercise, could induce changes in PPTs for the masseter muscle. In addition, only AO produced changes in tongue muscle strength. More research is needed to determine the role of brain representation techniques in the oro-facial region and transferring this exercise to the rehabilitation setting.

Action observation combined with gait training to improve gait and cognition in elderly with mild cognitive impairment A randomized controlled trial.

.Owing to advancement of medical technology and current knowledge, the population has a longer life expectancy, leading to an increase in the proportion of elderly.Objective:The study aimed to investigate the effect of action observation (AO) combined with gait training on gait and cognition in elderly with mild cognitive impairment (MCI).Methods:Thirty-three participants were randomly allocated to action observation with gait training (AOGT), gait training (GT), and control (CT) groups. The AOGT and GT groups received a program of observation and gait training protocol with the same total duration of 65 min for 12 sessions. For the observation, the AGOT group watched a video of normal gait movement, while the GT group watched an abstract picture and the CT group received no training program. All participants were assessed for gait parameters during single- and dual-tasks using an electronic gait mat system and were assessed for cognitive level using the Montreal Cognitive Assessment (MoCA) at baseline, after training and at 1-month follow-up.Results:The results showed that the AOGT group had significant improvements in gait speeds during single- and dual-tasks, as well as better MoCA score, while the GT group had significant improvement only in gait speed.Conclusion:The adjunct treatment of AO with gait training provides greater benefits for both gait and cognitive performances in elderly with MCI.