Purpose: The purpose of this study was to determine the effects of action observation training on lower limb muscle activity and dynamic balance in chronic stroke patients. Methods: This study evaluated 20 chronic stroke patients who were divided randomly into a control and an experimental group comprising 10 patients each. Both the experimental group and the control group performed the general exercise therapy provided by the hospital, but the experimental group also performed action observation training. Lower limb muscle activity was measured with a surface electromyograph, and dynamic balance was measured with the Timed Up and Go test and the 10-meter walk test. The paired t-test was used to compare the groups before and after the experiment. Furthermore, the independent t-test was used to assess differences in the degree of change between the two groups before and after the experiment. Results: The within-group comparisons for both the experimental group and the control group showed significant differences in muscle activity and dynamic balance (p<0.05). In a comparison between the groups, the differences in the muscle activity and dynamic balance of the experimental group appeared significant compared with those of the control group (p<0.05). Conclusion: The study results indicate that action observation training is effective in improving the muscle activity and dynamic balance of chronic stroke patients.
Purpose: The purpose of this study was to improve the quality of fundamental nursing practice course. Methods: Participants were 132 students who took the fundamental nursing practice course at D university in N city. The study included processes of planning, action, observation, and reflection. Quantitative data were analyzed using SPSS 20.0 program and qualitative data were evaluated through content analysis. Results: The 12-step designing college courses model by Fink was applied in the planning. In the acting stage, the course was conducted according to the instruction in designing the course, students wrote reflective journals and the professor gave feedback to the reflective journal and the class observation journal was used for lessons. In the observation stage, the course evaluation was surveyed and analyzed, evaluations were positive with 47.1% of students positively evaluating the teaching strategy. In the reflecting stage, outcomes in course improvement were reflected on and, the number of students at the lower level-of-achievement decreased. Conclusion: Action research was a useful research method that could capture the quality improvement process in college courses. Expression of effort and passion to improve quality of education through action research in various ways and to share quality improvement strategies for nursing education are important.
Purpose : The purpose of this article was to review the literature on mirror neuron system with reference to its functional diversity in stroke rehabilitation.. Method : This review outlines scientific findings regarding different neurophysiological properties in mirror neurons, and discusses their involvement in process of stroke rehabilitation. Result & Conclusions : Mirror neurons were first discovered in macaque monkey. These neurons, like most neurons in F5 areas in premotor cortex, fired when an individual performs an action, as well as when he/she observes a similar action done by another individual, although originally fired only during action execution. Mirror neurons form a network for motor planning and initiating of motor action. Thus, in stroke rehabilitation based on the mirror neuron-action observation, motor imagery, observation with intent to imitate and imitation-may help activate mirror neuron system for improved outcome of physical therapy. These studies provide a scientific theoretical basis and discuss for the use of mirror neuron system as a complement to clinical physical therapy in stroke rehabilitation.
Purpose: This study examined the effects of action observational training to improve the gait function for patients with stroke. Methods: The participants were divided into two groups: right hemiplegia group (n=12) and left hemiplegia group (n=12). All groups received conventional therapy for five sessions for 30 minutes, each for three weeks. Left and right hemiplegia group practiced additional action observational training for five sessions for 20 minutes each for three weeks. They participated in three weeks of action observational training coupled with immediate physical practice (intervention), followed by a final assessment. The duration of each action observation video sequence was 10 minutes, followed immediately by practice of the observed motor skill (10 minutes). The gait velocity, cadence, swing time, step length, and BOS (base of support) were examined using the GAITRite system. Results: The results of this study showed significant improvement in the gait function. The outcomes of the gait abilities from gait velocity, cadence, swing time, step length of the affected side, and BOS (base of support) were improved significantly in the right hemiplegia group (p<0.05). In the left hemiplegia group, there was no significant improvement in the gait velocity, cadence, and BOS except for the swing time and step length of the affected side. The left and right group comparisons between the groups were not significant (p<0.05). Conclusion: Action observation training improves the gait function. These results suggest that action observational training is feasible and suitable for stroke patients.
Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.
PURPOSE: This study examined the effects of action observational training with acoustic stimulation (AOTA) on the balance and gait ability in stroke patients. METHODS: Forty-five chronic stroke patients were divided into three groups. The AOTA group (n = 15) received training via a video that showed a normal gait with the sound of footsteps. The action observation training (AOT) group (n = 15) received AOT without acoustic stimulation. The control group (n = 15) received physical training. Each intervention was applied once per day, three times per week for six weeks. The participants in the AOTA and AOT groups had five minutes of AOT. The participants in the all group had 20 minutes of physical training. All participants were measured using the Berg Balance Scale, the Timed Up and Go Test, the Functional Reaching Test, 10 Meter Walk Test, six Minute Walk Test, and Dynamic Gait Index. The collected data were analyzed using SPSS version 20.0 for Windows. The between- and within-group comparisons were analyzed using the one-way analysis of variance (ANOVA) test and a paired t-test, respectively. For all statistical analyses, the significance level was set to .05. RESULTS: The one-way ANOVA test identified significant differences among the measurement results of the three groups (p < .05). Post hoc analyses indicated the AOTA group to undergo more significant balance and gait changes than the control group (p < .05). CONCLUSION: The gait and balance abilities could be improved effectively for patients with stroke when action observation training and acoustic stimulation were applied simultaneously.
PURPOSE: This study was conducted in chronic hemiplegic patients to examine the effect of the training of the ipsilateral arm that is identical to the model performing movements and the training of the contralateral arm on the function of the arm. METHODS: The subjects were participated total 2 patients(the subject 1 with left hemiplegia and the subject 2 with right hemiplegia). The study was conducted for 4 weeks. The action observation training were repeated 10 times in 10 days during intervention period. The evaluation of the arm function such as BBT, MFT and MAL in the each subject were examined 5 times in the baseline period, 10 times during the intervention period and 5 times during the baseline regression period. RESULTS: The results of the evaluation in each subject were presented as mean values and video graphs. The arm function of the 2 subjects were improved during the intervention period in comparison with the baseline period, and the improvement was maintained even during the regression baseline period. In addition, there were large variation ratio of BBT and MAL (AOU, QOM) in comparison with subject 1. CONCLUSION: According to the results, the action observation training was more effective in improving upper limb function of stroke patients who imitate the performed behavior of paralyed parts on the same side.
Purpose: This study examined the effects of changes in the intensity of Functional Electrical Stimulation (FES) on CorticoMuscular Coherence (CMC) during action observation. This paper presents a neurophysiological basis for the effective intensity of FES. Methods: Twenty-seven healthy volunteers were asked to observed a video with FES. The FES was provided with a sensory stimulation level, nerve stimulation level, and motor stimulation level. Simultaneously, an electroencephalogram (EEG) of the sensorimotor cortex and electromyogram (EMG) from the wrist extensor muscle were recorded. The peak CMC and average CMC were analyzed to compare the differences caused by the FES intensity. Results: The peak CMC showed a significant increase in the alpha band during motor stimulation (p<0.05). The average CMC showed a significant increase in the beta band during motor stimulation (p<0.05). Conclusion: The intensity of FES, which causes actual movement, increased the CMC during action observation. These results show that the intensity of the FES can affect the functional connection between the sensorimotor cortex and muscle.
Purpose: We compared the activation pattern of the mirror neurons (MN) between two types of hand movement according to action observation using functional MRI. Methods: Twelve right-handed healthy subjects (5 male and 7 female, mean age $21.92{\pm}2.02years$) participated in the experiment. During fMRI scanning, subjects underwent two different stimuli on the screen: 1) video clips showing repeated grasping and releasing of the ball via simple hand movement (SHM), and (2) video clips showing an actor performing a Purdue Pegboard test via complex hand movement (CHM). paired t-test in statistical parametric mapping (SPM) was used to compare the activation differences between the two types of hand movement. Results: CHM as compared with the SHM produced a higher blood oxygen level dependent (BOLD) signal response in the right superior frontal gyrus, left inferior and superior parietal lobules, and lingual gyrus. However, no greater BOLD signal response was found by SHM compared with CHM (FWE corrected, p<0.05). Conclusion: Our findings provided that the activation patterns for observation of SHM and CHM are different. CHM also elicited boarder or stronger activations in the brain, including inferior parietal lobule called the MN region.
Purpose : The object of this study was to examine the effect of motor learning on brain activation depending on the method of motor learning. Methods : The brain activation was measured in 9 men by fMRI. The subjects were divided into the following groups depending on the method of motor learning: actually practice (AP, n=3) group, action observation (AO, n=3) group and motor imagery (MI, n=3) group. In order to examine the effect of motor learning depending on the method of motor learning, the brain activation data were measured during learning. For the investigation of brain activation, fMRI was conducted. Results : The results of brain activation measured before and during learning were as follows; (1) During learning, the AP group showed the activation in the following areas: primary motor area located in precentral gyrus, somatosensory area located in postcentral gyrus, supplemental motor area and prefrontal association area located in precentral gyrus, middle frontal gyrus and superior frontal gyrus, speech area located in superior temporal gyrus and middle temporal gyrus, Broca's area located in inferior parietal lobe and somatosensory association area of precuneus; (2) During learning, the AD groups showed the activation in the following areas: primary motor area located in precentral gyrus, prefrontal association area located in middle frontal gyrus and superior frontal gyrus, speech area and supplemental motor area located in superior temporal gyrus and middle temporal gyrus, Broca's area located in inferior parietal lobe, somatosensory area and primary motor area located in precentral gyrus of right cerebrum and left cerebrum, and somatosensory association area located in precuneus; and (3) During learning, the MI group showed activation in the following areas: speech area located in superior temporal gyrus, supplemental area, and somatosensory association area located in precuneus. Conclusion : Given the results above, in this study, the action observation was suggested as an alternative to motor learning through actual practice in serial reaction time task of motor learning. It showed the similar results to the actual practice in brain activation which were obtained using activation of mirror neuron. This result suggests that the brain activation occurred by the activation of mirror neuron, which was observed during action observation. The mirror neurons are located in primary motor area, somatosensory area, premotor area, supplemental motor area and somatosensory association area. In sum, when we plan a training program through physiotherapy to increase the effect during reeducation of movement, the action observation as well as best resting is necessary in increasing the effect of motor learning with the patients who cannot be engaged in actual practice.
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