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  • Title: Does Action Observation Training With Immediate Physical Practice Improve Hemiparetic Upper-Limb Function in Chronic Stroke?
    Author: Sugg K, Müller S, Winstein C, Hathorn D, Dempsey A.
    Journal: Neurorehabil Neural Repair; 2015 Oct; 29(9):807-17. PubMed ID: 25613984.
    Abstract:
    BACKGROUND: The mirror neuron network provides a neural mechanism to prime the motor system through action observation in stroke survivors. OBJECTIVE: To examine whether action observation training with immediate physical practice improves upper-limb function in chronic stroke. METHODS: In a within-subject design, 14 chronic stroke survivors were assessed at baseline, then participated in 2 weeks of relaxation-sham plus physical practice (control) and reassessed. Thereafter, they participated in 2 weeks of action observation training coupled with immediate physical practice (intervention), followed by a final assessment. Duration of each action observation video sequence (priming exposure) was 30 s followed immediately by practice of the observed motor skill. RESULTS: There were significant improvements in control and intervention phases on primary outcome measures--Upper Extremity Fugl-Meyer Motor Assessment (FMA) and Functional Test of the Hemiparetic Upper Extremity (FTHUE)--as well as secondary outcome measures of self-perceptions of arm use. Gains in the primary outcomes were greater during the intervention phase (action observation + physical practice; FMA, 10.64; FTHUE level, 0.79, and tasks, 1.57) than during the control phase (relaxation-sham plus physical practice; FMA, 6.64; FTHUE level, 0.43, and tasks, 1.00). Interviews with participants highlighted the added value of watching an actor perform the movement before physically attempting to perform the action. CONCLUSIONS: This study provides preliminary evidence of the additive value of action observation plus physical practice over relaxation-sham plus physical practice. There appears to be capacity for further recovery of upper-limb function in chronic stroke that persists at least in the short term.
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