• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.137-145
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• 2018

PURPOSE: The purpose of this study was to investigate the effect of action observational physical training with rhythmic auditory stimulation on muscle activity and gait ability in patients with stroke. METHODS: Twenty-six chronic stroke patients participated in this study were assigned into three groups, experimental group 1 (10% faster tempo rhythmic auditory stimulation with action observation training) n=8, experimental group 2 (average tempo rhythmic auditory stimulation with action observation training) n=9, and control group (action observation training) n=9. In this experiment, the corresponding exercise were applied into the subjects of three group for 30 minute a day, 3 time a week during 4 weeks. All participants were measured to muscle activity of lower limb, 10 meter walking test, Figure of 8 walk test, Dynamic gait Index. The collected data were analyzed by using SPSS (version 18.0 for window) and verified that each data was a normal distribution based on Shapiro-Wilk test. Between-group and within-group comparison was analyzed by using One-way ANOVA test, Paired t-test respectively. In all statistical analyses, significance level, ${\alpha}$ was set by .05. RESULTS: The above results revealed that the all experimental group 1 and experimental group 2 and control group were all effective to improve the lower limb muscle activities, gait ability. However more positive effects shown action observational physical training with rhythmic auditory stimulation experimental group. CONCLUSION: This study suggest that action observation physical training with rhythmic auditory stimulation is effective intervention for improvement of muscle activity and walking ability in chronic stroke patients.

• PNF and Movement
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• v.13 no.4
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• pp.175-180
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• 2015

Purpose: This study aimed to examine the effects of mirror-neuron-system-based action observation physical training on improvements in upper extremity functions and daily living activities in chronic stroke patients. Methods: Ten chronic stroke patients were randomly selected. As a therapeutic intervention, along with conventional occupational therapy, the patients engaged in action observation physical training through repeated imitation practices after they viewed a video. The therapeutic intervention was implemented for 20 minutes, three times each week for eight weeks. A Manual Function Test (MFT) was conducted to compare upper extremity functions before and after the therapeutic intervention, and the Modified Barthel Index (MBI) was used to compare the ability to perform daily living activities. Results: Significant improvements in upper extremity motor functions and the ability to perform daily living activities were shown after the intervention. The subjects' left upper extremity motor functions and ability to perform daily living activities showed significant improvement after the intervention. Conclusion: The study's results indicate that action observation physical training based on the mirror neuron system improves chronic stroke patients' upper extremity motor functions and their ability to perform daily living activities. Therefore, action observation training has positive effects on the functional recovery of chronic stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3759-3765
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• 2014

This study examined the effects of action observations on the balance of patients with chronic stroke. The study period was between July 8, 2013 and August 10 2013. The participants were divided randomly into either the landscape picture observation group (n=20) and the action observation group (n=20). Each group observed the landscape pictures and video-recorded action-related balance for 5 minutes, respectively. Both groups had a balance training session for 10 minutes after the picture and video observations. The balance training sessions were repeated twice a day, three times a week for 6 weeks. As a result, significant improvement was noted in the action observation group than the landscape picture observation group for static balance and dynamic balance (p<.05). Consequently, the combination of action observation and balance training is believed to help improve the balance recovery for patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.27 no.6
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• pp.413-418
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• 2015

Purpose: This study was performed to examine the effect of action observation training on sit to-walk times in chronic stroke patients. Methods: Twelve stroke patients were randomly allocated to two groups, as follows: an action observation training (AOT) group and a scenery picture observation (SPO) group. The AOT group was engaged in video observation for 2 minutes 30 seconds with 12 ADL functional activities related to the sit-to-walk task: physical training was carried out in two repetitions lasting 2 minutes 30 seconds. The landscape imagery control group observed landscape picture for 2 minutes 30 seconds and then carried out the same physical training. The intervention involved a total of 12 sessions over 4 weeks, and each session lasted 30 minutes. The pre and post-tests measured the timed up and go test (TUG), Sit to stand test (STS), and Dynamic gait index (DGI). The Wilcoxon signed ranks test was used to compare pre-test and post-test result, and the Mann-Whitney U test was employed for comparison between groups. Results: The TUG time was significantly different between the AOT group and the SPO group. According to the findings, the experimental group's TUG was significantly decreased (p<0.05). In comparison of the two groups, there was no significant in STS or DGI between the AOT group and SPO group. Conclusion: This study showed that the intervention can be used to decrease TUG time. Our research suggests that action observation training has a positive effect on sit-to-walk times in patients with chronic stroke.

• The Journal of Korean Physical Therapy
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• v.29 no.5
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• pp.246-254
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• 2017

Purpose: Previous studies have reported that action observation training has beneficial effects on enhancing the motor task, such as balance and gait functions. On the other hand, there have been few studies combined with action observation training and auditory feedback. The purpose of this study was to determine the effects of action observation training with auditory feedback on the gait function in stroke patients with hemiparesis Methods: A total of 24 inpatients with post-stroke hemiparesis were assigned randomly to either an experimental group 1 (EG 1, n=8), experiment group 2 (EG 2, n=8), control group (CG, n=8, EG 1). The EG 2 and CG watched video clip demonstrating three functional walking tasks with auditory feedback, without auditory feedback, and showing a landscape image, respectively. The exercise program consisted of 30 minutes, five times a week, for four weeks. The participants were measured to 10MWT (10 m walk test), 6MWT (6 minutes walking distance test), TUG (timed up and go test), DGI (dynamic gait index), time and steps of F8WT (figure-of-8 walk test). Results: In the intra-group comparison after the intervention, EG 1 and EG 2 showed a significantly different gait function (10MWT, 6MWT, DGI, TUG, F8WT) (p<0.05). In the inter-group comparison after intervention, EG 1 showed significant improvements in the entire gait parameters and EG 2 only showed significant improvement in DGI and TUG compared to CG (p<0.05). Conclusion: These findings show that action observation training with auditory feedback may be used beneficially for improving the gait function of stroke patients with hemiparesis.

• PNF and Movement
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• v.12 no.1
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• pp.19-25
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• 2014

Purpose: To investigate the effect of action observation training on the muscle onset time and symmetrical use of rectus femoris(RF) and gastrocnemius medialis(GCM) during sit-to-stand (STS). Methods: Sixteen patients with stroke entered a single-blind trial and were randomly assigned to the experimental(Action) or control(Landscape) groups. Those in the Action observation group watched video clips showing specific movement and strategies to STS, wheas those in the control group watched video clips of static pictures showing differnet landscapes. All patients was measured the EMG data in the STS on the affected side and unaffected side. The EMG data were collected from RF and GCM while performing the STS task. The EMG onset time and onset time ratio for the RF and GCM were calculated by dividing the EMG onset time of RF and GCM action on the affected side by these on the unaffected side. Results: Onset time of affected side RF, GCM was significantly faster action observation training group than control group(p<.05). But interventions before and after the symmetry did not show a significant increase. Conclusion: There findings suggest that action observation training has a positive effect on the muscle onset time shortened during STS tasks.

• 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.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.135-139
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• 2015

Purpose: The aim of this study was to compare EEG topographical maps in patients with chronic stroke after action observation physical training. Methods: Ten subjects were recruited from a medical hospital. Participants observed the action of transferring a small block from one box to another for 6 sessions of 1 minute each, and then performed the observed action for 3 minutes, 6 times. An EEG-based brain mapping system with 32 scalp sites was used to determine cortical reorganization in the regions of interest (ROIs) during observation of movement. The EEG-based brain mapping was comparison in within-group before and after training. ROIs included the primary sensorimotor cortex, premotor cortex, superior parietal lobule, inferior parietal lobule, superior temporal lobe, and visual cortex. EEG data were analyzed with an average log ratio in order to control the variability of the absolute mu power. The mu power log ratio was in within-group comparison with paired t-tests. Results: Participants showed activation prior to the intervention in all of the cerebral cortex, whereas the inferior frontal gyrus, superior frontal gyrus, precentral gyrus, and inferior parietal cortex were selectively activated after the training. There were no differences in mu power between each session. Conclusion: These findings suggest that action observation physical training contributes to attaining brain reorganization and improving brain functionality, as part of rehabilitation and intervention programs.

• PNF and Movement
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• v.12 no.2
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• pp.123-132
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• 2014

Purpose: The discovery of mirror neuron system may positively affect functional recovery; therefore, rehabilitation is needed that is practical for use in clinical settings. The purpose of this study was to examine the effect of action observation training on upper motor function in people who had suffered strokes. Methods: Three elderly patients with stroke, aged to years, were recruited from a stroke rehabilitation center. A nonconcurrent, multiple baseline subject approach was taken, with an A-B-A treatment single-subject experimental design, and the experiment was conducted for 3 weeks. The action observation training was repeated 5 times in 5 days during the intervention period. The arm function, including WMFT, BBT, and grip and pinch strength, was evaluated in each subject 5 times during the baseline period, the intervention period, and the baseline regression period. Results: The results of the evaluation for each subject were presented as mean values and video graphs. The WMFT scores of 2 subjects were improved during the intervention period in comparison with the baseline period, and this improvement was maintained even during the regression baseline period. The BBT and the grip and pinch strength were not improved. Conclusion: Based on these results, we suggest that the action observation training for 5 sessions was effective in improving upper limb function of stroke patients but was not effective in improving hand dexterity or grip and pinch strength.

• 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.