• Journal of the Korean Society of Physical Medicine
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• v.11 no.1
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• PNF and Movement
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• v.14 no.3
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• pp.209-217
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• 2016

Purpose: Treatments using a mirror neuron system, such as 3D virtual reality therapy, are used in stroke rehabilitation, but they need to be constructed according to a detailed procedure. The aims of this study were to analyze electroencephalograms (EEG) during relaxation and action while observing first person perspective (1AE) and third person perspective (3AE) videos of the right hand for 20's. Methods: Thirty participants (Male=4, Female=26) were recruited for this study. Participants were selected by a vividness of movement imagery questionnaire (VMIQ). EEG was measured during relaxxation and during action with 1AE and 3AE videos, focusing on the supination and pronation actions of participants' right hands. An absolute mu rhythm, a relatively high alpha power, and a relative beta power were identified. In each group, one-way repeated measures ANOVA was used for statistical analysis. Results: Measurement of absolute mu rhythms was significantly suppressed for both 1AE and 3AE compared with relaxation in C3 and C4 regions. High alpha wave measurements were significantly suppressed for both 1AE and 3AE in all regions, while beta wave measurements were significantly increased only for 3AE in F3 and F4 regions. Conclusion: Based on this study, we suggest that the mirror neuron system is activated during actions accompanied by action observation, especially actions with 3AE video observation, which can be a great therapeutic mathod in stroke rehabilitation.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.7-14
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• 2019

PURPOSE: This study examined the effects of observing a self-video or a video of another person performing balance and gait training, followed by actual performance of the observed movements on the balance and walking ability of chronic stroke patients. METHODS: Thirty patients, who had experienced a stroke and were admitted to S rehabilitation hospital for treatment, were selected randomly and divided into three groups with 10 patients each: self-action observation (SAO) group, other-action observation (OAO) group, and treadmill walking training (TWT) group. The training program was conducted five times per week for four weeks. The GAITRite system, 10 m walking test, and timed up and go test were performed to measure the subjects' gait and balance ability. RESULTS: The velocity, cadence, double support, and stride length were increased significantly in the SAO and OAO groups (p<.05) but the T group showed no significant changes; no significant difference was observed among the groups (p >.05). The 10MWT decreased significantly in the OAO group (p<.05), but there were no significant changes in the SAO and T groups, and no significant difference was observed among the groups (p>.05). The TUG decreased significantly in the SAO and OAO groups (p<.05), but there were no significant changes in the T group, and no significant difference was observed among the groups (p>.05). CONCLUSION: The self or other action observation training helps improve the balance and gait ability.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.98-103
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• 2022

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.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.93-102
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• 2016

PURPOSE: The purpose of this study is to evaluate the functional effects of action observation plus functional electrical stimulation (FES) treatment on the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities, and stride lengths of stroke patients. METHODS: The subjects, who were all more than six months post stroke, were randomly divided into two groups of ten each: an experimental group and a control group. TETRAX (Tetrax Interactive Balance System) and GAITRite (GAITRite$^{TM}$ computerized gait analysis system) were measured at baseline, six weeks after treatment. Participants in both the groups received functional electrical stimulation treatment, but the experimental group was provided with additional action observation. Independent t-tests were used to compare the differences between the groups, and repeated measured two-way ANOVA was used to compare the interaction between the groups. RESULTS: The result of the interactions between the groups and the periods showed significant increases in the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities and stride lengths (p<0.05). However, a comparison between the groups showed no significance in the weight distribution indexes (heel and toe), stability indexes, and stride lengths (p>0.05). CONCLUSION: Action observation plus functional electrical stimulation treatment should be considered as a therapeutic method for physical therapy for stroke patients to improve the weight distribution indexes, stability indexes, gait velocities, and stride lengths.

• Physical Therapy Korea
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• v.22 no.1
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• pp.69-78
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• 2015

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A') was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.53-58
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• 2017

Background: The purpose of this study was to effect of action observation with deep neck flexors strengthening exercise on pain and function in patients with chronic neck pain. Methods: Thirty patients with chronic neck pain were randomly action observation with deep neck flexors strengthening exercise group (AOT group; n=15) and deep neck flexors strengthening exercise group (FSE group; n=15). The intervention was applied for 50 minutes a day, 5 times a week for a total of 4 weeks. The intervention effect were evaluated before and after the intervention. visual analogue scale (VAS), pressure pain threshold (PPT), and Korea neck disability index (KNDI). Results: As a result of comparing within group, AOT group showed pre and post test, VAS (p<.01), PPT (p<.01), KNDI (p<.01) and FSE group VAS (p<.01), PPT (p<.05), KNDI (p<.01) significantly. In the comparison between the two groups, AOT group than FSE group in VAS, PPT and KNDI significantly (p<.05). Conclusion: Action observation with deep neck flexors strengthening exercise were founded to effective in reducing pain and improving function in patients with chronic neck pain. It is suggested as basic data of clinical intervention.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.119-130
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• 2019

Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.

• Physical Therapy Korea
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• v.27 no.3
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• Journal of the Korea Convergence Society
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• v.9 no.12
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• pp.123-128
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• 2018

The aim of this study was to determine the effects of the action observation and visual feedback on the alignment, pain and function of forward head posture(FHP) and round shoulder(RS). A total of 24 participants with FHP and RSP were randomly assigned to general exercise(GE, n=8), action observation(AO, n=8), and visual feedback(VF, n=8). All subjects were exercised three times a week for four weeks. The groups were assessed for craniovertebral angle(CVA), round shoulder posture(RSP), visual analog scale(VAS), and neck disability index(NDI) before and after exercise, There was a significant difference in CVA in the GE, AO and RSP, VAS and NDI were significantly different in all groups. AO was more effective than GE, VF for VAS. The results of this study suggest that action observation may be effective to improve the FHP and RS.