• The Journal of Korean Physical Therapy
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• v.31 no.3
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• pp.157-160
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• 2019

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.

• Therapeutic Science for Rehabilitation
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• v.5 no.2
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• pp.71-80
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• 2016

Objective: To illustrate effects and application potential of Mirror Therapy (MT) for patients with post-stroke hemiplegia. Method: With reference to 9 journals (published Jan.2005-Jan.2016) on Pubmed, selected based on in/exclusion standards. Result: Simple wrist/hand movements and task-based MT were used as intervention methods to examine the effects. Tools used to assess intervention effects included upper limb functioning, Activities of Daily Living (ADL), physical condition and quality of life. Upper limb functioning turned out to have significance for ADL with higher effectiveness at the distal than the proximal region. Yet the quality of life disparity between the experiment group and the control was not found to be significant. Conclusion: We believe that research can aid clinical therapists in applying MT accordingly to individual patient characteristics. Despite prolonged difficulty in confirming efficient application due to varied protocols, development of systemized treatment protocols for maximization of MT's effectiveness remains necessary.

• 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.18 no.3
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• pp.47-53
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• 2023

PURPOSE: A visual feedback method was proposed to induce brain stimulation in a stroke patient, and among them, there was a treatment using a mirror. On the other hand, mirror therapy focuses only on the functional changes in body movements, and analysis of neurophysiological mechanisms of brain activity is lacking. In addition, studies on evaluating the activity and response generated in specific brain regions during visual feedback training using mirrors are insufficient. METHODS: Fifteen healthy adults (male: 10, female: 5, Years: 23.33 ± 1.23), who were right-handed were recruited. By attaching the C3, Cz, and C4 channels in the sensorimotor cortex using an electroencephalogram, training was performed under the conditions without mirror-based visual feedback (No-condition) and with visual feedback (Tasks-condition). At this time, the immediate activity of the mu-rhythm in response to training was separated and evaluated. RESULTS: The tasks-condition of C3, Cz, and C4 channels activated the relative mu-rhythm rather than the no-condition, and all showed significant differences (p < .05). In addition, in all channels at the start time, the tasks-condition was more active than the no-condition (p < .05). The activity of the cortical response was higher in the tasks-condition than in the no-condition (p < .05). CONCLUSION: The mu-rhythm activity can be evaluated objectively when visual feedback using a mirror is applied to healthy subjects, and a basic analysis protocol is proposed.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.3
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• pp.395-404
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• 2010

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.

• 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.

• Physical Therapy Korea
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• v.18 no.2
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• pp.27-34
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• 2011

The aim of this study was to determine the effect of action-observation training on arm function in people with stroke. Fourteen chronic stroke patients participated in action-observation training. Initially, they were asked to watch video that illustrated arm actions used in daily activities; this was followed by repetitive practice of the observed actions for 3 times a week for 3 weeks. Each training session lasted 30 min. All subject participated 12 training session on 9 consecutive training days. For the evaluation of the clinical status of standard functional scales, Wolf motor function test was carried out at before and after the training and at 2 weeks after the training. Friedman test and Wilcoxon signed rank test was used to analyze the results of the clinical test. There was a significant improvement in the upper arm functions after the 3-week action-observation training, as compared to that before training. The improvement was sustained even at two weeks after the training. This result suggest that action observation training has a positive additional impact on recovery of stroke-induced motor dysfunctions through the action observation-action execution matching system, which includes in the mirror neuron system.

• Journal of the Korean Society of Physical Medicine
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• v.3 no.4
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• pp.269-276
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• 2008

Purpose : The purpose of this study was to evaluate the effects of mirror movements(MM) on upper extremity's function and measure the change of MM on stroke patients depending on the elapse of time. Methods : Sixteen stroke patients with MM and Sixteen stroke patients without MM were recruited for this study. Intended movements and MM were measured by two dynanometers of MP150 system(BIOPAC System Inc., Santa Barbara, U.S.A). The upper extremity's motor function was measured using manual function test(MFT), Fugl-Meyer assesment(FMA). Results : The change rates of upper extremity's motor function test showed significant group differences in FMA but not in MFT between the patients with MM and without MM from the first test to the second test. In each group motor function generally more increased. The magnitudes of MM decreased from the first test to the second test. Conclusion : These results indicate that stroke patients with MM have a significant motor deficit. But motor deficit could be recovered by spontaneous recovery or treatments and a clinical sign of MM was improved. In the future, we suggest that studies of assessments of MM after rehabilitation and treatment interventions of MM on stroke patients.

• PNF and Movement
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• v.9 no.2
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• pp.39-44
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• 2011

Purpose : This study was aimed to examine the Influence of PNF indirect treatment for frozen shoulder patient Methods : Frozen shoulder patient was measured range of motion test of shoulder joint, visual analog scale(VAS) for pain and clean up the mirror activity at pre intervention and post-intervention in 2 weeks. Results : The ROM, activities of shoulder were increased and decreased VAS point for pain after treatments. Conclusion : We found that PNF indirect treatment could improve ROM and functions of shoulder and pain for frozen shoulder patient.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.3
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• pp.233-246
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• 2022

Purpose : The study aims to determine the effects of virtual and non-virtual realities in a normal person's mirror walk on gait characteristics. Methods : Twenty male adults (Age: 27.8 ± 5.8 years) participated in the study. Reflection markers were attached to the subjects for motion analysis, and they walked in virtual reality environments with mirrors by wearing goggles that showed them the virtual environments. After walking in virtual environments, the subjects walked in non-virtual environments with mirrors a certain distance away after taking a 5 min break. To prevent the order effect caused by the experiential difference of gait order, the subjects were randomly classified into groups of 10 and the order was differentiated. During each walk, an infrared camera was used to detect motion and the marker positions were saved in real time. Results : Comparison between the virtual and non-virtual reality mirror walks showed that the movable range of the leg joints (ankle, knee, and hip joints), body joints (sacroiliac and atlantoaxial joints), and arm joints (shoulder and wrist joints) significantly differed. Temporal characteristics showed that compared to non-virtual gaits, the virtual gaits were slower and the cycle time and double limb support time of virtual gaits were longer. Furthermore, spacial characteristics showed that compared to non-virtual gaits, virtual gaits had shorter steps and stride lengths and longer stride width and horizontally longer center of movement. Conclusion : The reduction in the joint movement in virtual reality compared to that in non-virtual reality is due to adverse effects on balance and efficiency during walking. Moreover, the spatiotemporal characteristics change based on the gait mechanisms for balance, exhibiting that virtual walks are more demanding than non-virtual walks. However, note that the subject group is a normal group with no abnormalities in gait and balance and it is unclear whether the decrease in performance is due to the environment or fear. Therefore, the effects of the subject group's improvement and fear on the results need to be analyzed in future studies.