DOI QR코드

DOI QR Code

Effects of Action Observation Training Combied with Auditory Cueing on Gait Ability in Patients with Stroke: a Preliminary Pilot Study

  • Kim, Hyeong-Min (Department of Physical Therapy, College of Health Science, Cheongju University) ;
  • Son, Sung-Min (Department of Physical Therapy, College of Health Science, Cheongju University) ;
  • Ko, Yu-Min (Department of Physical Therapy, Gangneung Yeongdong University)
  • Received : 2022.05.17
  • Accepted : 2022.06.22
  • Published : 2022.06.30

Abstract

Purpose: New therapeutic approaches have emerged to improve gait ability in patients with brain damage, such as action observation learning (AOT), auditory cueing, motor imagery etc. We attempted to investigate the effects of AOT with auditory cueing (AOTAC) on gait function in patients with stroke. Methods: The eighteen stroke patients with a unilateral hemiparesis were randomly divided into three groups; the AOTAC, AOT, and control groups. The AOTAC group (n=8) received training via observing a video that showed normal gait with sound of footsteps as an auditory cue; the AOT group (n=6) receive action observation without auditory stimulation; the control group (n=5) observed the landscape video image. Intervention time of three groups was 30 minutes per day, five times a week, for four weeks. Gait parameters, such as cadence, velocity, stride length, stance phase, and swing phase were collected in all patients before and after each training session. Results: Significant differences were observed among the three groups with respect to the parameters, such as cadence, velocity, stride length, and stance/swing phase. Post-hoc analysis indicated that the AOTAC group had a greater significant change in all of parameters, compared with the AOT and control groups. Conclusion: Our findings suggest that AOTAC may be an effective therapeutic approach to improve gait symmetry and function in patients with stroke. We believe that this effect is attributable to the change of cortical excitability on motor related to cortical areas.

Keywords

References

  1. Garland SJ, Gray VL, Knorr S. Muscle activation patterns and postural control following stroke. Motor Control. 2009;13(4):387-411. https://doi.org/10.1123/mcj.13.4.387
  2. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009;8(8):741-54. https://doi.org/10.1016/S1474-4422(09)70150-4
  3. Li S, Liu J, Bhadane M et al. Activation deficit correlates with weakness in chronic stroke: evidence from evoked and voluntary EMG recordings. Clin Neurophysiol. 2014;125(12):2413-7. https://doi.org/10.1016/j.clinph.2014.03.019
  4. Patel M. Action observation in the modification of postural sway and gait: theory and use in rehabilitation. Gait Posture. 2017;58:115-20. https://doi.org/10.1016/j.gaitpost.2017.07.113
  5. Chisari C, Bertolucci F, Monaco V et al. Robot-assisted gait training improves motor performances and modifies motor unit firing in poststroke patients. Eur J Phys Rehabil Med. 2015:51(1):59-69.
  6. In T, Lee K, Song C. Virtual reality reflection therapy improves balance and gait in patients with chronic stroke: randomized controlled trials. Med Sci Monit. 2016;22:4046-53. https://doi.org/10.12659/MSM.898157
  7. Chung SH, Kim JH, Yong SY. Effect of task-specific lower extremity training on cognitive and gait function in stroke patients: a prospective randomized controlled trial. Ann Rehabil Med. 2019;43(1):1-10. https://doi.org/10.5535/arm.2019.43.1.1
  8. Park HJ, Oh DW, Choi JD. Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial. Clin Rehabil. 2017;31(8):1078-86. https://doi.org/10.1177/0269215516671982
  9. Guerra ZF, Lucchetti ALG, Lucchetti G. Motor imagery training after stroke: a systematic review and meta-analysis of randomized controlled trials. J Neurol Phys Ther. 2017;41(4):205-14. https://doi.org/10.1097/npt.0000000000000200
  10. Chang MC, Kim DY, Park DH. Enhancement of cortical excitability and lower limb motor function in patients with stroke by transcranial direct current stimulation. Brain Stimul. 2015;8(3):561-6. https://doi.org/10.1016/j.brs.2015.01.411
  11. Jarvelainen J, Schurmann M, Hari R. Activation of the human primary motor cortex during observation of tool use. Neuroimage. 2004;23(1):187-92. https://doi.org/10.1016/j.neuroimage.2004.06.010
  12. Rizzolatti G, Cattaneo L, Fabbri-Destro M et al. Cortical mechanisms underlying the organization of goal-directed actions and mirror neuron-based action understanding. Physio Rev. 2014;94(2):655-706. https://doi.org/10.1152/physrev.00009.2013
  13. Rizzolatti G, Fogassi L, Gallese V. Neurophysiological mechanisms underlying the understanding and imitation of action. Nat Rev Neurosci. 2001;2(9):661-70. https://doi.org/10.1038/35090060
  14. Franceschini M, Ceravolo MG, Agosti M et al. Clinical relevance of action observation in upper-limb stroke rehabilitation: a possible role in recovery of functional dexterity. a randomized clinical trial. Neurorehabil Neural Repair. 2012;26(5):456-62. https://doi.org/10.1177/1545968311427406
  15. Garrison KA, Aziz-Zadeh L, Wong SW et al. Modulating the motor system by action observation after stroke. Stroke. 2013;44(8):2247-53. https://doi.org/10.1161/STROKEAHA.113.001105
  16. Harmsen WJ, Bussmann JB, Selles RW et al. A mirror therapy-based action observation protocol to improve motor learning after stroke. Neurorehabil Neural Repair. 2015;29(6):509-16. https://doi.org/10.1177/1545968314558598
  17. Gatti R, Tettamanti A, Gough PM et al. Action observation versus motor imagery in learning a complex motor task: a short review of literature and a kinematics study. Neurosci Lett. 2013;540:37-42. https://doi.org/10.1016/j.neulet.2012.11.039
  18. Murgia M, Pili R, Corona F et al. The use of footstep sounds as rhythmic auditory stimulation for gait rehabilitation in parkinson's disease: a randomized controlled trial. Front Neurol. 2018;9:348. https://doi.org/10.3389/fneur.2018.00348
  19. Park J, Park SY, Kim YW et al. Comparison between treadmill training with rhythmic auditory stimulation and ground walking with rhythmic auditory stimulation on gait ability in chronic stroke patients: a pilot study. NeuroRehabilitation. 2015;37(2):193-202. https://doi.org/10.3233/nre-151252
  20. Shin YK, Chong HJ, Kim SJ et al. Effect of rhythmic auditory stimulation on hemiplegic gait patterns. Yonsei Med J. 2015;56(6):1703-13. https://doi.org/10.3349/ymj.2015.56.6.1703
  21. Cha Y, Kim Y, Hwang S et al. Intensive gait training with rhythmic auditory stimulation in individuals with chronic hemiparetic stroke: a pilot randomized controlled study. NeuroRehabilitation. 2014;35(4):681-8. https://doi.org/10.3233/nre-141182
  22. Sale P, Ceravolo MG, Franceschini M. Action observation therapy in the subacute phase promotes dexterity recovery in right-hemisphere stroke patients. BioMed Res Int. 2014;2014:457538. https://doi.org/10.1155/2014/457538
  23. Kim JC, Lee HM. The effect of action observation training on balance and sit to walk in chronic stroke: a crossover randomized controlled trial. J Mot Behav. 2018;50(4):373-80. https://doi.org/10.1080/00222895.2017.1363697
  24. Kim JH, Lee BH. Action observation training for functional activities after stroke: a pilot randomized controlled trial. NeuroRehabilitation. 2013;33(4):565-74. https://doi.org/10.3233/nre-130991
  25. Buccino G, Solodkin A, Small SL. Functions of the mirror neuron system: implications for neurorehabilitation. Cog Behav Neurol. 2006;19(1):55-63. https://doi.org/10.1097/00146965-200603000-00007
  26. Celnik P, Stefan K, Hummel F et al. Encoding a motor memory in the older adult by action observation. NeuroImage. 2006;29(2):677-84. https://doi.org/10.1016/j.neuroimage.2005.07.039
  27. Agosta F, Gatt R, Sarasso E et al. Brain plasticity in parkinson's disease with freezing of gait induced by action observation training. J Neurol. 2017;264(1): 88-101. https://doi.org/10.1007/s00415-016-8309-7
  28. Di Iorio W, Ciarimboli A, Ferriero G et al. Action observation in people with parkinson's disease. a motor-cognitive combined approach for motor rehabilitation. a preliminary report. Diseases. 2018;6(3):58. https://doi.org/10.3390/diseases6030058
  29. Sarasso E, Gemma M, Agosta F et al. Action observation training to improve motor function recovery: a systematic review. Arch Physiother. 2015;5:14. https://doi.org/10.1186/s40945-015-0013-x
  30. Bang DH, Shin WS, Kim SY et al. The effects of action observational training on walking ability in chronic stroke patients: a double-blind randomized controlled trial. Clin Rehabil. 2013;27(12):1118-25. https://doi.org/10.1177/0269215513501528
  31. Calvo-Merino B, Glaser DE, Grezes J et al. Action observation and acquired motor skills: an FMRI study with expert dancers. Cereb Cortex. 2005;15(8):1243-49. https://doi.org/10.1093/cercor/bhi007
  32. Calvo-Merino B, Grezes J, Glaser DE et al. Seeing or doing? influence of visual and motor familiarity in action observation. Curr Biol. 2006;16(19):1905-10. https://doi.org/10.1016/j.cub.2006.07.065
  33. Mainka S, Wissel J, Voller H et al. The use of rhythmic auditory stimulation to optimize treadmill training for stroke patients: a randomized controlled trial. Front Neurol. 2018;9:755. https://doi.org/10.3389/fneur.2018.00755
  34. Thaut MH, McIntosh GC, Prassas SG et al. Effect of rhythmic auditory cuing on temporal stride parameters and EMG patterns in hemiparetic gait of stroke patients. J Neuro Rehab. 1993;7(1): 9-16.
  35. Song JH, Zhou PY, Cao ZH et al. Rhythmic auditory stimulation with visual stimuli on motor and balance function of patients with Parkinson' s disease. Eur Rev Med Pharmacol Sci. 2015;19(11): 2001-7.