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Ringsten M, Ivanic B, Iwarsson S, Lexell EM. Interventions to improve outdoor mobility among people living with disabilities: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1407. [PMID: 38882933 PMCID: PMC11177337 DOI: 10.1002/cl2.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 06/18/2024]
Abstract
Background Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer activities outside the home. Outdoor mobility interventions aim to improve the ability to move, travel and orient outside the home and could influence the number of activities outside the home, participation and quality of life. However, outdoor mobility interventions may also lead to harm like falls or injuries or have unforeseen effects which could lead to mortality or hospitalization. Objectives To assess the efficacy of interventions aiming to improve outdoor mobility for adults living with disabilities and to explore if the efficacy varies between different conditions and different intervention components. Search Methods Standard, extensive Campbell search methods were used, including a total of 12 databases searched during January 2023, including trial registries. Selection Criteria Only randomized controlled trials were included, focusing on people living with disabilities, comparing interventions to improve outdoor mobility to control interventions as well as comparing different types of interventions to improve outdoor mobility. Data Collection and Analysis Standard methodological procedures expected by Campbell were used. The following important outcomes were 1. Activity outside the home; 2. Engagement in everyday life activities; 3. Participation; 4. Health-related Quality of Life; 5. Major harms; 6. Minor harms. The impact of the interventions was evaluated in the shorter (≤6 months) and longer term (≥7 months) after starting the intervention. Results are presented using risk ratios (RR), risk difference (RD), and standardized mean differences (SMD), with the associated confidence intervals (CI). The risk of bias 2-tool and the GRADE-framework were used to assess the certainty of the evidence. Main Results The screening comprised of 12.894 studies and included 22 studies involving 2.675 people living with disabilities and identified 12 ongoing studies. All reported outcomes except one (reported in one study, some concerns of bias) had overall high risk of bias. Thirteen studies were conducted in participants with disabilities due to stroke, five studies with older adults living with disabilities, two studies with wheelchair users, one study in participants with disabilities after a hip fracture, and one study in participants with cognitive impairments. Skill training interventions versus control interventions (16 studies) The evidence is very uncertain about the benefits and harms of skill training interventions versus control interventions not aimed to improve outdoor mobility among all people living with disabilities both in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Skill training interventions may improve engagement in everyday life activities among people with disabilities in the shorter term (RR: 1.46; 95% CI: 1.16 to 1.84; I 2 = 7%; RD: 0.15; 95% CI: -0.02 to 0.32; I 2 = 71%; 692 participants; three studies; low certainty evidence), but the evidence is very uncertain in the longer term, based on very low certainty evidence. Subgroup analysis of skill training interventions among people living with disabilities due to cognitive impairments suggests that such interventions may improve activity outside the home in the shorter term (SMD: 0.44; 95% CI: 0.07 to 0.81; I 2 = NA; 118 participants; one study; low certainty evidence). Subgroup analysis of skill training interventions among people living with cognitive impairments suggests that such interventions may improve health-related quality of life in the shorter term (SMD: 0.49; 95% CI: 0.12 to 0.88; I 2 = NA; 118 participants; one study; low certainty evidence). Physical training interventions versus control interventions (five studies) The evidence is very uncertain about the benefits and harms of physical training interventions versus control interventions not aimed to improve outdoor mobility in the shorter term (≤6 months) and longer term (≥7 months) for: Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Physical training interventions may improve activity outside the home in the shorter (SMD: 0.35; 95% CI: 0.08 to 0.61; I 2 = NA; 228 participants; one study; low certainty evidence) and longer term (≥7 months) (SMD: 0.27; 95% CI: 0.00 to 0.54; I 2 = NA; 216 participants; one study; low certainty evidence). Comparison of different outdoor mobility interventions (one study) The evidence is very uncertain about the benefits and harms of outdoor mobility interventions of different lengths in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. No studies explored the efficacy of other types of interventions. Authors’ Conclusions Twenty-two studies of interventions to improve outdoor mobility for people living with disabilities were identified, but the evidence still remains uncertain about most benefits and harms of these interventions, both in the short- and long term. This is primarily related to risk of bias, small underpowered studies and limited reporting of important outcomes for people living with disabilities. For people with disabilities, skill training interventions may improve engagement in everyday life in the short term, and improve activity outside the home and health-related quality of life for people with cognitive impairments in the short term. Still, this is based on low certainty evidence from few studies and should be interpreted with caution. One study with low certainty evidence suggests that physical training interventions may improve activity outside the home in the short term. In addition, the effect sizes across all outcomes were considered small or trivial, and could be of limited relevance to people living with disabilities. The evidence is currently uncertain if there are interventions that can improve outdoor mobility for people with disabilities, and can improve other important outcomes, while avoiding harms. To guide decisions about the use of interventions to improve outdoor mobility, future studies should use more rigorous design and report important outcomes for people with disabilities to reduce the current uncertainty.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and Development Skåne University Hospital Lund Sweden
- Department of Health Sciences Lund University Lund Sweden
| | | | | | - Eva Månsson Lexell
- Department of Health Sciences Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and Geriatrics Skåne University Hospital Lund-Malmö Sweden
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Biswas A, Rao PD, Madhavan S, Natarajan M, Solomon JM. Video parameters for action observation training in stroke rehabilitation: a scoping review. Disabil Rehabil 2024; 46:1256-1265. [PMID: 37021345 DOI: 10.1080/09638288.2023.2191016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 03/08/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Action observation training (AOT) is a therapeutic approach used in stroke rehabilitation. Videos form the core of AOT, and knowledge of constituent parameters is essential to make the intervention robust and generalizable. Currently, there is a dearth of available information on video parameters to be used for AOT. Our purpose was to identify and describe the parameters that constitute AOT videos for stroke rehabilitation. METHOD Electronic databases like PubMed, CINAHL, Scopus, Web of Science, ProQuest, and Ovid SP from inception to date according to PRISMA-ScR guidelines. Title, abstract, and full-text screening were done independently by two authors, with a third author for conflict resolution. Data on video parameters like length, quality, perspective, speed, screen size and distance, sound, and control videos were extracted. RESULTS Seventy studies were included in this review. The most-reported parameters were video length (85.71%) and perspective of view (62.85%). Movement speed (7.14%) and sound (8.57%) were the least reported. Static landscapes or geometrical patterns were found suitable as control videos. CONCLUSION Most video parameters except for length and perspective of view remain underreported in AOT protocols. Future studies with better descriptions of video parameters are required for comprehensive AOT interventions and result generalisation.
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Affiliation(s)
- Arunima Biswas
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Prajna D Rao
- College of Physiotherapy, Srinivas University, Mangalore, India
| | - Sangeetha Madhavan
- Department of Physical Therapy, University of Illinois, Chicago, IL, USA
| | - Manikandan Natarajan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, India
| | - John M Solomon
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, India
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Shamsi F, Aligholi H, Karimi MT, Borhani-Haghighi A, Nami M. Quantitative EEG for the Monitoring of Walking Recovery in Chronic Stroke Patients Receiving Action Observation Training. J Mot Behav 2024; 56:428-438. [PMID: 38408745 DOI: 10.1080/00222895.2024.2320904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
The current study aimed to evaluate the effects of action observation on the walking ability and oscillatory brain activity of chronic stroke patients. Fourteen chronic stroke patients were allocated randomly to the action observation (AO) or sham observation (SO) groups. Both groups received 12 sessions of intervention. Each session composed of 12 min of observational training, which depicted exercises for the experimental group but nature pictures for the sham group and 40 min of occupational therapy, which was the same for the both groups. Walking ability was assessed by a motion analysis system and brain activity was monitored using quantitative electroencephalography (QEEG) before and after the intervention. Brain asymmetry at alpha frequency, the percentage of stance phase, and step length showed significant changes in the AO group. Only the change in global alpha power was significantly correlated with the change in velocity after the intervention in AO group. Despite more improvements in walking and brain activity of patients in the AO group, our study failed to show significant correlations between the brain activity changes and functional improvements after the intervention, which might be mainly due to the small sample size in our study. Trial registration: IRCT20181014041333N1.
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Affiliation(s)
- Fatemeh Shamsi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Aligholi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Taghi Karimi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Center, Instituto de Investigaciones Científicas Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, Panama
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Zhang C, Li X, Wang H. Application of action observation therapy in stroke rehabilitation: A systematic review. Brain Behav 2023; 13:e3157. [PMID: 37480161 PMCID: PMC10454263 DOI: 10.1002/brb3.3157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/09/2023] [Accepted: 07/06/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Numerous studies have described the positive effects of action observation therapy (AOT) on motor recovery among patients with stroke. However, there is no standardized procedure for when and how to intervene with AOT. OBJECTIVES Thus, we reviewed and analyzed previous studies to provide a guideline for the application of AOT in stroke rehabilitation. METHOD We searched PubMed, Cochrane Library, and EMBASE from inception to October 31 2022, using title and abstract search terms of "action observation" and "stroke" or "hemiplegia." Of 4108 potential articles, 29 articles (sample size = 429 in AOT groups; sample size = 423 in control groups) that met inclusion criteria were included in final analyses. RESULTS The results suggested starting adjuvant AOT > 23 days after stroke onset and conducting 30-40 min/session, 3-5 times/week for at least 4 weeks. CONCLUSION Based on our results, many factors will impact the effect of AOT on stroke rehabilitation, when to apply (timing) and how to apply (frequency, single, and total duration) should be fully considered when applying AOT as adjuvant therapy in stroke rehabilitation.
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Affiliation(s)
- Chenping Zhang
- Department of Physical EducationShanghai University of Medicine & Health SciencesShanghaiChina
| | - Xiawen Li
- Department of Physical EducationShanghai University of Medicine & Health SciencesShanghaiChina
| | - Hongbiao Wang
- Department of Physical EducationShanghai University of Medicine & Health SciencesShanghaiChina
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Sánchez Silverio V, Abuín Porras V, Rodríguez Costa I, Cleland JA, Villafañe JH. Effects of action observation training on the walking ability of patients post stroke: a systematic review. Disabil Rehabil 2022; 44:7339-7348. [PMID: 34644226 DOI: 10.1080/09638288.2021.1989502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine the effect of action observation (AO) training on the walking ability of patients post stroke. METHODS MEDLINE, CINAHL, EMBASE and PEDro were searched systematically for human studies written in English up to August 31st 2021. Two authors screened titles and abstracts against predefined inclusion criteria; a third author resolved discrepancies. Data were analyzed through qualitative synthesis. Articles evaluating the effects of AO training on the walking ability of patients post stroke were included. Methodological quality was assessed using the PEDro scale. RESULTS From first search that included 1,578 studies, 7 were included in this review. According to the PEDro scale, most of the studies exhibited a methodological quality between Good and Fair (N = 6). Most of the studies applied a protocol based on a 30-minute training session applied 3 to 5 times per week over a 4-week period (N = 5). Using clinical measures and gait parameters, all studies confirmed the beneficial effects of AO training on walking ability. However, the effects of AO training on walking ability were not confirmed at the long-term follow-up. CONCLUSIONS AO training has a positive effect on the walking ability of patients post stroke. Additional studies are needed to confirm these results across the entire spectrum of patient's post stoke including long-term clinical effects.Implications for RehabilitationAction observation training can have potentially positive effects on the walking ability of stroke patients.Clinical measurements (10-meter walk test) and gait parameters (stride length and gait speed) could be used to assess the effect of action observation training on walking ability.The patient's concentration is an important factor to consider when applying observational training.
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Affiliation(s)
- Víctor Sánchez Silverio
- School of Applied Health Sciences, Pontificia Universidad Católica Madre y Maestra, Santiago De Los Caballeros, Dominican Republic
| | - Vanesa Abuín Porras
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain Madrid.,Fundación DACER. Área de investigación, Madrid, Spain
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Shamsi F, Nami M, Aligholi H, Borhani-Haghighi A, Kavyani M, Karimi MT. The effect of action observation training on gait and balance of patients with neurological and musculoskeletal disorders: A systematic review. Br J Occup Ther 2022. [DOI: 10.1177/03080226221098943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Various treatment approaches are being applied for recovery of gait after different medical conditions. Action observation is a new motor learning approach, which is considered as a complementary training to the conventional rehabilitation programs such as occupational therapy for this purpose. Objective To find out which patients benefit more from action observation training. Methods Electronic databases, including Scopus, PubMed, Web of Science, Science Direct, and PEDro were searched. Prospective studies published in peer-reviewed journals with full text available in English, which investigated the effect of action observation on gait and balance of patients with neurologic or musculoskeletal disorders, were included. The methodological quality of the studies was assessed by the Downs and Black checklist, and the information was presented based on the PICO style. Results Nineteen studies recruiting post-orthopedic patients (4 studies), patients with stroke (11 studies), and Parkinson’s disease (4 studies) fulfilled the eligibility criteria. Quality scores ranged from 51.85% to 81.48%. Balance and walking ability were the most reported primary outcomes. Conclusion Patients in the chronic phase of stroke might benefit more from action observation training plus occupational therapy in different aspects of gait than orthopedic patients and those with Parkinson’s disease.
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Affiliation(s)
- Fatemeh Shamsi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Center, Instituto de Investigaciones Científicas Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, Panama
| | - Hadi Aligholi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Laboratory (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahsa Kavyani
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad T Karimi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Moon Y, Bae Y. The effect of backward walking observational training on gait parameters and balance in chronic stroke: randomized controlled study. Eur J Phys Rehabil Med 2022; 58:9-15. [PMID: 34468110 PMCID: PMC9980533 DOI: 10.23736/s1973-9087.21.06869-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Backward walking (BW) and action observation training may potentially help people at risk of falls. Moreover, action observation training could be a potential intervention to improve gait after a stroke. AIM We aimed to identify the effects of BW action observational training (BWOT) on gait parameters and balance in chronic stroke patients. DESIGN Randomized, controlled study. SETTING Rehabilitation center. POPULATION Twenty-four chronic stroke patients were randomly assigned to BWOT (N.=12) and landscape observational training (LOT) (N.=12) groups. METHODS The BWOT group performed BW after watching a video of a BW, while the LOT group performed BW training after watching a video of a landscape. Both groups received traditional therapy for 5 days per week and BWOT for 3 days a week for 4 weeks. The primary and secondary outcomes were gait and balance, respectively. Static balance was measured using the 5 Times Sit-To-Stand Test (5TSTS), the center of pressure (COP) displacement, and weight distribution (WD) of the affected side. Dynamic balance was measured using the activity-specific balance confidence (ABC) scale. RESULTS The BWOT group showed significant improvements in gait velocity (p=0.001, η2=0.470), step length (P=0.007, η2=0.313), stride lengths (P<0.002, η2=0.431), 5TSTS (P=0.021, η2=0.231), COP velocity (P=0.022, η2=0.226), length (P=0.001, η2=0.504), WD of the affected side (P=0.033, η2=0.193), and ABC score (P=0.023, η2=0.226) than the LOT group. CONCLUSIONS The 4-week BWOT training program significantly improved the gait parameters and static and dynamic balance in stroke patients. CLINICAL REHABILITATION IMPACT BWOT is an accessible and effective method of rehabilitation training that can also be applied to conventional therapy as a useful method for improving the gait and balance after stroke.
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Affiliation(s)
- Yiyeop Moon
- Department of Physical Therapy, Godoil Spine and Pain Hospital, Seoul, Republic of Korea
| | - Youngsook Bae
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea -
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The effects of action observation training as an add-on rehabilitation strategy on the walking ability of patients with chronic stroke. J Bodyw Mov Ther 2022; 29:33-39. [DOI: 10.1016/j.jbmt.2021.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/21/2021] [Accepted: 09/24/2021] [Indexed: 10/20/2022]
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Biswas A, Natarajan M, Subramanian SK, Solomon JM. Development and feasibility testing of action observation training videos in acute stroke survivors: Preliminary findings. F1000Res 2022; 11:524. [PMID: 36891251 PMCID: PMC9986771 DOI: 10.12688/f1000research.118969.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 02/11/2023] Open
Abstract
Background: Action observation training (AOT) is used for lower limb (LL) stroke rehabilitation in subacute and chronic stages, but concise information regarding the types of activities to be used and the feasibility of administration in the acute stroke population is unknown. The aim of this study was to develop and validate videos of appropriate activities for LL AOT and test administrative feasibility in acute stroke. Method: A video inventory of LL activities was created after a literature survey and expert scrutiny. Five stroke rehabilitation experts validated the videos per domains of relevance, comprehension, clarity, camera position and brightness. LL AOT was then tested on ten individuals with acute stroke for uncovering barriers for clinical use in a feasibility study. Participants watched the activities and attempted imitation of the same. Determination of administrative feasibility was undertaken via participant interviews. Results: Suitable LL activities for stroke rehabilitation were identified. Content validation of videos led to improvements in selected activities and video quality. Expert scrutiny led to further video processing to include different perspectives of view and speeds of projected movements. Barriers identified included inability to imitate actions shown in videos and increased distractibility for some participants. Conclusion: A video catalogue of LL activities was developed and validated. AOT was deemed safe and feasible for acute stroke rehabilitation and may be used in future research and clinical practice.
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Affiliation(s)
- Arunima Biswas
- Department of Physiotherapy, Manipal College of Health Professions,Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Manikandan Natarajan
- Department of Physiotherapy, Manipal College of Health Professions,Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.,Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Sandeep K Subramanian
- Department of Physiotherapy, Manipal College of Health Professions,Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.,Departments of Physical Therapy, Physician Assistant Studies and Rehabilitation Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - John M Solomon
- Department of Physiotherapy, Manipal College of Health Professions,Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.,Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, 576104, India
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Alhasani R, Radman D, Auger C, Lamontagne A, Ahmed S. Clinicians and individuals with acquired brain injury perspectives about factors that influence mobility: creating a core set of mobility domains among individuals with acquired brain injury. Ann Med 2021; 53:2365-2379. [PMID: 34894914 PMCID: PMC8676689 DOI: 10.1080/07853890.2021.2015539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To identify factors which may influence mobility and could be considered during the evaluation of mobility in individuals with acquired brain injury (ABI) following qualitative focus groups with both clinicians and individuals with ABI, to assess their needs and preferences in order to individualize their care management plans. METHODS Five focus groups were held, three with clinicians from 3 rehabilitation sites of CRIR (CRDM: n = 4; IURDPM: n = 3; JRH: n = 10) and two with individuals with ABI from one rehabilitation site (CRDM) (individuals with stroke: n = 5; individuals with TBI: n = 5). Focus group discussions were transcribed and analyzed using inductive and deductive thematic content approaches. RESULTS Four themes were identified: considering mobility holistically and individual needs, preferences, and unique experiences; assessment and intervention guidelines; support network; and uncertainty about symptoms and recovery. Using the ten-rule International Classification, Functioning, Disability, and Health framework linking process, codes were categorized into Body Functions Activity and Participation, and Environmental Factors exploring the prominent domains that mostly identify factors influencing mobility. CONCLUSIONS Comprehensive measurement of mobility remains an ongoing challenge owing to multiple contributing factors, ranging from personal and psychosocial factors to the influence of a myriad of environmental and community considerations. Preparing individuals with ABI for community mobility can be substantially improved if healthcare professionals employ communicative tools to facilitate shared decision making with patients and to deliver patient-centred rehabilitation care.
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Affiliation(s)
- Rehab Alhasani
- Faculty of Medicine, School of Physical and Occupation Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Dennis Radman
- Faculty of Medicine, School of Physical and Occupation Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Claudine Auger
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Anouk Lamontagne
- Faculty of Medicine, School of Physical and Occupation Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Jewish Rehabilitation Hospital, CISSS de Laval, Laval, Canada
| | - Sara Ahmed
- Faculty of Medicine, School of Physical and Occupation Therapy, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Constance Lethbridge Rehabilitation Center, CIUSSS Centre-Ouest de l'Îile de Montreal, Montreal, Canada
- McGill University Health Center Research Institute, Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), Montreal, Canada
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Rizzolatti G, Fabbri-Destro M, Nuara A, Gatti R, Avanzini P. The role of mirror mechanism in the recovery, maintenance, and acquisition of motor abilities. Neurosci Biobehav Rev 2021; 127:404-423. [PMID: 33910057 DOI: 10.1016/j.neubiorev.2021.04.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/12/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
While it is well documented that the motor system is more than a mere implementer of motor actions, the possible applications of its cognitive side are still under-exploited, often remaining as poorly organized evidence. Here, we will collect evidence showing the value of action observation treatment (AOT) in the recovery of impaired motor abilities for a vast number of clinical conditions, spanning from traumatological patients to brain injuries and neurodegenerative diseases. Alongside, we will discuss the use of AOT in the maintenance of appropriate motor behavior in subjects at risk for events with dramatic physical consequences, like fall prevention in elderly people or injury prevention in sports. Finally, we will report that AOT can help to tune existing motor competencies in fields requiring precise motor control. We will connect all these diverse dots into the neurophysiological scenario offered by decades of research on the human mirror mechanism, discussing the potentialities for individualization. Empowered by modern technologies, AOT can impact individuals' safety and quality of life across the whole lifespan.
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Affiliation(s)
- Giacomo Rizzolatti
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Parma, Italy
| | | | - Arturo Nuara
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Parma, Italy; Università di Modena e Reggio Emilia, Dipartimento di Scienze Biomediche, Metaboliche, e Neuroscienze, Modena, Italy
| | - Roberto Gatti
- Istituto Clinico Humanitas, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Pietro Avanzini
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Parma, Italy; Istituto Clinico Humanitas, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
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Hnin HH, Bovonsunthonchai S, Witthiwej T, Vachalathiti R, Ariyaudomkit R. Feasibility of action observation effect on gait and mobility in idiopathic normal pressure hydrocephalus patients. Dement Neuropsychol 2021; 15:79-87. [PMID: 33907600 PMCID: PMC8049582 DOI: 10.1590/1980-57642021dn15-010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Action observation (AO) has been proved to be of benefit in several neurological
conditions, but no study has previously been conducted in idiopathic normal
pressure hydrocephalus (iNPH).
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Affiliation(s)
- Htet Htet Hnin
- Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand.,Gait and Balance Group, Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand
| | - Sunee Bovonsunthonchai
- Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand.,Gait and Balance Group, Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand
| | - Theerapol Witthiwej
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University - Bangkok, Thailand
| | | | - Rattapha Ariyaudomkit
- Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand.,Gait and Balance Group, Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand
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13
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Ryan D, Fullen B, Rio E, Segurado R, Stokes D, O’Sullivan C. Effect of Action Observation Therapy in the Rehabilitation of Neurologic and Musculoskeletal Conditions: A Systematic Review. Arch Rehabil Res Clin Transl 2021; 3:100106. [PMID: 33778479 PMCID: PMC7984987 DOI: 10.1016/j.arrct.2021.100106] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To investigate the effect of action observation therapy (AOT) in the rehabilitation of neurologic and musculoskeletal conditions. DATA SOURCES Searches were completed until July 2020 from the electronic databases Allied and Complementary Medicine Database (via OVID SP), Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EMBASE, MEDLINE, and the Physiotherapy Evidence Database. STUDY SELECTION Randomized controlled trials comparing AOT with standard care were assessed. Musculoskeletal (amputee, orthopedic) and neurologic (dementia, cerebral palsy, multiple sclerosis, Parkinson disease, stroke) conditions were included. There were no age limitations. Articles had to be available in English. DATA EXTRACTION Two reviewers independently screened titles, abstracts and full extracts of studies for eligibility and assessed the risk of bias of each study using the Cochrane Risk of Bias Tool. Data extraction included participant characteristics and intervention duration, frequency, and type. RESULTS The effect of AOT in different outcome measures (OMs) was referenced in terms of body structures and functions, activities and participation, and environmental factors as outlined by the International Classification of Functioning, Disability, and Health (ICF). Of the 3448 articles identified, 36 articles with 1405 patients met the inclusion criteria. Seven of the 11 meta-analyses revealed a significant effect of intervention, with results presented using the mean difference and 95% CI. A best evidence synthesis was used across all OMs. Strong evidence supports the use of AOT in the rehabilitation of individuals with stroke and Parkinson disease; moderate evidence supports AOT in the rehabilitation of populations with orthopedic and multiple sclerosis diagnoses. However, moderate evidence is provided for and against the effect of AOT in persons with Parkinson disease and cerebral palsy. CONCLUSIONS This review suggests that AOT is advantageous in the rehabilitation of certain conditions in improving ICF domains. No conclusions can be drawn regarding treatment parameters because of the heterogeneity of the intervention. AOT has been considerably less explored in musculoskeletal conditions.
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Key Words
- 10MWT, 10-m walk test
- ADL, activities of daily living
- AHA, Assisting Hand Assessment
- AOT, action observation therapy
- BBS, Berg Balance Scale
- BBT, Box and Block Test
- FOG, freezing of gait
- ICF, International Classification of Functioning Disability, and Health
- MAS, Modified Ashworth Scale
- MCID, minimum clinically important difference
- MD, mean difference
- MDC, minimal detectable change
- MI, motor imagery
- MNS, mirror neuron system
- MUUL, Melbourne Assessment of Unilateral Upper Limb Function
- Neuronal plasticity
- OM, outcome measures
- PDQ-39, 39-item Parkinson Disease Questionnaire
- ROM, range of motion
- Rehabilitation
- RoB, risk of bias
- SF-36, Short Form-36 Health Survey
- Systematic review
- TUG, Timed Up and Go
- UPDRS, Unified Parkinson Disease Rating Scale
- VAS, Visual Analog Scale
- WOMAC, Western Ontario McMaster Universities Osteoarthritis Index
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Affiliation(s)
- Deirdre Ryan
- UCD School of Public Health, Physiotherapy, and Sports Science, Dublin, Ireland
| | - Brona Fullen
- UCD School of Public Health, Physiotherapy, and Sports Science, Dublin, Ireland
| | - Ebonie Rio
- School of Allied Health, La Trobe University Melbourne, Melbourne, Victoria, Australia
| | - Ricardo Segurado
- UCD School of Public Health, Physiotherapy, and Sports Science, Dublin, Ireland
| | | | - Cliona O’Sullivan
- UCD School of Public Health, Physiotherapy, and Sports Science, Dublin, Ireland
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14
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Paci M, Prestera C, Ferrarello F. Generalizability of Results from Randomized Controlled Trials in Post-Stroke Physiotherapy. Physiother Can 2020; 72:382-393. [PMID: 35110812 PMCID: PMC8781507 DOI: 10.3138/ptc-2018-0117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Purpose: The randomized controlled trial (RCT) is considered a reliable experimental design, able to detect the effect of an intervention. However, a criticism frequently levelled at RCTs by clinicians is their lack of generalizability. This study aimed to evaluate the generalizability of findings from RCTs of physiotherapy interventions for individuals with stroke. Method: A sample of RCTs of physiotherapy interventions after stroke indexed in the PEDro database was selected, and the reported inclusion and exclusion criteria were analyzed. Results: We reviewed 100 articles, which included 7,366 participants (41.6% women, with a mean weighted age of 65.5 years). The most frequent criteria for exclusion were comorbidity (83%), cognitive impairments (69%), communication skills (55%), recurrent stroke (53%), low functional level (47%) and being elderly (25%). Conclusions: A variety of cohorts of individuals who have had a stroke are excluded from RCTs published in the field of physiotherapy. Because they represent a substantial proportion of the real-world population with stroke, and consequently treated in clinical practice, more vulnerable cohorts of participants should be included in RCTs.
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Affiliation(s)
- Matteo Paci
- Unit of Functional Recovery, Azienda USL Toscana Centro, Florence
| | - Claudia Prestera
- Rehabilitation Center, Fondazione Filippo Turati Onlus, Gavinana, Pistoia, Italy
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15
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Hioka A, Tada Y, Kitazato K, Akazawa N, Takagi Y, Nagahiro S. Action observation treatment improves gait ability in subacute to convalescent stroke patients. J Clin Neurosci 2020; 75:55-61. [PMID: 32234334 DOI: 10.1016/j.jocn.2020.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/20/2020] [Indexed: 11/18/2022]
Abstract
The aim of this study was to investigate the effects of action observation treatment (AOT) on gait ability in patients with subacute to convalescent stroke. Sixteen patients with subacute stroke were divided into a control group (n = 8) and AOT group (n = 8) when admitted to the convalescent ward. The control group received a conventional rehabilitation only. In addition to conventional rehabilitation, the AOT received AOT for 3 months (30 min per day 5 times per week). The AOT involved observing the action of another subject in a comfortable gait situation from the front, sides, and back via video and conducting the actual action. All participants were assessed during the main-assessment period, which included a baseline (i.e., when admitted to the convalescent ward) and 1, 2, and 3 months after baseline. The sub-assessment period at 2 and 3 months after baseline was conducted with participants who could walk independently. The main outcomes of the main-assessment and sub-assessment periods were Functional Ambulation Classification (FAC) and the 10-m walk test (10MWT), respectively. With respect to the FAC, we used a split plot design analysis of covariance to test the interaction between assessment time and group. There was no significant interaction between assessment time and group in FAC. However, a significant improvement of the 10MWT in the sub-assessment period was observed in the AOT group, but not the control group. Our results indicate that AOT may be an effective therapy for patients with subacute to convalescent stroke who can walk independently.
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Affiliation(s)
- Akemi Hioka
- Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima City, Japan.
| | - Yoshiteru Tada
- Department of Neurosurgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima City, Japan
| | - Keiko Kitazato
- Department of Neurosurgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima City, Japan
| | - Naoki Akazawa
- Department of Physical Therapy, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima City, Japan
| | - Yasushi Takagi
- Department of Neurosurgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima City, Japan
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16
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Jung YG, Oh DW, Park HJ, Han SH. Comparison of the effects of action observation training of community ambulation with different observational views on walking function in patients with chronic stroke: single-subject experimental study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2019.1645881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yun-Gu Jung
- Department of Rehabilitation Medicine, CNC Yul-Ryang Hospital, Cheongju-si, Republic of Korea
| | - Duck-Won Oh
- Department of Physical Therapy, College of Health Science, Cheongju University, Republic of Korea
| | - Hyun-Ju Park
- Department of Physical Therapy, College of Health Science, Cheongju University, Republic of Korea
| | - Soo-Hwan Han
- Department of Rehabilitation Medicine, CNC Yul-Ryang Hospital, Cheongju-si, Republic of Korea
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17
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Buchignani B, Beani E, Pomeroy V, Iacono O, Sicola E, Perazza S, Bieber E, Feys H, Klingels K, Cioni G, Sgandurra G. Action observation training for rehabilitation in brain injuries: a systematic review and meta-analysis. BMC Neurol 2019; 19:344. [PMID: 31881854 PMCID: PMC6935205 DOI: 10.1186/s12883-019-1533-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 11/15/2019] [Indexed: 12/21/2022] Open
Abstract
Background To systematically review and analyse the effects of Action Observation Training on adults and children with brain damage. Methods Seven electronic databases (Cochrane, EBSCO, Embase, Eric, PubMed, Scopus and Web of Science) were searched up to 16 September 2018 to select Randomized Controlled Trials focused on adults and children with brain damage that included AOT training on upper and/or lower limb carried out for at least 1 week. Identification of studies and data extraction was conducted with two reviewers working independently. Oxford Centre for Evidence-based Medicine (March2009) – Levels of Evidence and Physiotherapy Evidence Database scale were used to grade studies. The data collected from the articles were analysed using software R, version 3.4.3. Hedge’s g values were calculated and effect size estimates were pooled across studies. Separate meta-analyses were carried out for each ICF domain (i.e. body function and activity) for upper and lower limb. Results Out of the 210 records identified after removing duplicates, 22 were selected for systematic review and 19 were included in the meta-analysis. Thirteen studies included in the meta-analysis focused on upper limb rehabilitation (4 in children and 9 in adults) and 6 on lower limb rehabilitation (only studies in adults). A total of 626 patients were included in the meta-analysis. An overall statistically significant effect size was found for upper limb body function (0.44, 95% CI: [0.24, 0.64], p < 0.001) and upper limb activity domain (0.47, 95% CI: [0.30, 0.64], p < 0.001). For lower limb, only the activity domain was analysed, revealing a statistically significant overall effect size (0.56, 95% CI: [0.28, 0.84], p < 0.001). Conclusions Action Observation Training (AOT) is an innovative rehabilitation tool for individuals with brain damage, which shows promising results in improving the activity domain for upper and lower limbs, and also the body function domain for the upper limb. However, the examined studies lack uniformity and further well-designed, larger controlled trials are necessary to determine the most suitable type of AOT particularly in children. Systematic review registration CRD42019119600.
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Affiliation(s)
- Bianca Buchignani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy
| | - Elena Beani
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy
| | - Valerie Pomeroy
- Acquired Brain Injury Rehabilitation Alliance, School of health Sciences, University of East Anglia, Research Park, Norwich, NR31 9HL, UK
| | - Oriana Iacono
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy
| | - Elisa Sicola
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy
| | - Silvia Perazza
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy
| | - Eleonora Bieber
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy
| | - Hilde Feys
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Katrijn Klingels
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.,Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppina Sgandurra
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Viale del Tirreno 331, 56128 Calambrone, Pisa, Italy. .,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
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18
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PARK JISU, CHOI JONGBAE, LEE GIHYOUN, LEE SANGHOON, JUNG YOUNGJIN. EFFECT OF MOTOR IMAGERY TRAINING IN COMBINATION WITH ELECTROMYOGRAPHY-TRIGGERED ELECTRICAL STIMULATION IN STROKE WITH HEMIPLEGIA PATIENTS: A RANDOMIZED CONTROLLED STUDY. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419400621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recently, motor imagery training combined with electromyography-triggered electrical stimulation (MIT EMG-ES) has been reported as a remedial treatment for stroke patients. However, the clinical evidence of the effect is still lacking. To investigate the effect of MIT EMG-ES on lower extremities and activities of daily of living (ADL) in patients with stroke, the participants were randomly assigned to an experimental group ([Formula: see text]) or control group ([Formula: see text]). The experimental group underwent MIT EMG-ES, whereas the control group performed underwent motor imagery training. In addition, both groups received the same conventional rehabilitation therapy. All participants underwent treatment for 30[Formula: see text]min a day, 5 sessions per week, for 4 weeks. Lower extremities function was measured by the Fugl–Meyer Assessment Lower Extremity (FMA-LE), Timed Up-and-Go (TUG) test and 10 m Walk (10[Formula: see text]MW) test. ADL were measured by the Korea version of the Modified Barthel Index (K-MBI). The experimental group except for the FMA-LE group showed more improvement in TUG and 10[Formula: see text]MW test scores than the control group ([Formula: see text]). The effect size showed FMA-LE, TUG, and 10[Formula: see text]MW test (0.7, 1.0, 0.7, respectively). However, there was no statistically significant difference between the two groups in K-MBI ([Formula: see text]). Our findings suggest that MIT EMG-ES may be a novel treatment for lower extremities function in patients with stroke better than MIT alone.
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Affiliation(s)
- JI-SU PARK
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan, Republic of Korea
| | - JONG-BAE CHOI
- Department of Occupational Therapy, KyungHee Medical Center, Seoul, Republic of Korea
| | - GIHYOUN LEE
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - SANG-HOON LEE
- Department of Rehabilitation Science, Graduate School, Inje University, South Korea
| | - YOUNGJIN JUNG
- Department of Radiological Science, Dongseo University, Busan, Republic of Korea
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19
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Peng TH, Zhu JD, Chen CC, Tai RY, Lee CY, Hsieh YW. Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke: a systematic review and meta-analysis. Clin Rehabil 2019; 33:1277-1285. [DOI: 10.1177/0269215519839108] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective:This study was to investigate the effectiveness of action observation therapy on arm and hand motor function, walking ability, gait performance, and activities of daily living in stroke patients.Design:Systematic review and meta-analysis of randomized controlled trials.Data sources:Searches were completed in January 2019 from electronic databases, including PubMed, Scopus, the Cochrane Library, and OTseeker.Review methods:Two independent reviewers performed data extraction and evaluated the study quality by the PEDro scale. The pooled effect sizes on different aspects of outcome measures were calculated. Subgroup analyses were performed to examine the impact of stroke phases on treatment efficacy.Results:Included were 17 articles with 600 patients. Compared with control treatments, the action observation therapy had a moderate effect size on arm and hand motor outcomes (Hedge’s g = 0.564; P < 0.001), a moderate to large effect size on walking outcomes (Hedge’s g = 0.779; P < 0.001), a large effect size on gait velocity (Hedge’s g = 0.990; P < 0.001), and a moderate to large effect size on activities of daily function (Hedge’s g = 0. 728; P = 0.004). Based on subgroup analyses, the action observation therapy showed moderate to large effect sizes in the studies of patients with acute/subacute stroke or those with chronic stroke (Hedge’s g = 0.661 and 0.783).Conclusion:This review suggests that action observation therapy is an effective approach for stroke patients to improve arm and hand motor function, walking ability, gait velocity, and daily activity performance.
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Affiliation(s)
- Tzu-Hsuan Peng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
| | - Jun-Ding Zhu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
| | - Chih-Chi Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Ruei-Yi Tai
- Department of Neurology, Taipei Medical University Hospital, Taipei
- Taipei Neuroscience Institute, Taipei Medical University, Taipei
| | - Chia-Yi Lee
- Department of Physical Medicine and Rehabilitation, Cathay General Hospital, Taipei
| | - Yu-Wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou
- Healthy Aging Research Center, Chang Gung University, Taoyuan
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20
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Kawasaki T, Tozawa R, Aramaki H. Effectiveness of using an unskilled model in action observation combined with motor imagery training for early motor learning in elderly people: a preliminary study. Somatosens Mot Res 2018; 35:204-211. [DOI: 10.1080/08990220.2018.1527760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Tsubasa Kawasaki
- Institute of Sports Medicine and Science, Tokyo International University, Kawagoe-City, Saitama, Japan
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu-City, Chiba, Japan
| | - Ryosuke Tozawa
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu-City, Chiba, Japan
| | - Hidefumi Aramaki
- Department of Physical Therapy, Faculty of Health Science, Ryotokuji University, Urayasu-City, Chiba, Japan
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21
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Activation of mirror neuron system during gait observation in sub-acute stroke patients and healthy persons. J Clin Neurosci 2018; 60:79-83. [PMID: 30318398 DOI: 10.1016/j.jocn.2018.09.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/27/2018] [Indexed: 11/24/2022]
Abstract
The observation of walking improves gait ability in chronic stroke survivors. It has also been suggested that activation of the mirror neuron system contributes to this effect. However, activation of the mirror neuron system during gait observation has not yet been assessed in sub-acute stroke patients. The objective of this study was to clarify the activation of mirror neuron system during gait observation in sub-acute stroke patients and healthy persons. In this study, we sequentially enrolled five sub-acute stroke patients who had undergone gait training and nine healthy persons. We used fMRI to detect neuronal activation during gait observation. During the observation period in the stroke group, neural activity in the left inferior parietal lobule, right and left inferior frontal gyrus was significantly higher than during the rest period. In the healthy group, neural activity in the left inferior parietal lobule, left inferior frontal gyrus, left middle frontal gyrus, left superior temporal lobule and right and left middle temporal gyrus was significantly higher than during the rest period. The results indicate that the mirror neuron system was activated during gait observation in sub-acute stroke patients who had undergone gait training and also in healthy persons. Our findings suggest that gait observation treatment may provide a promising therapeutic strategy in sub-acute stroke patients who have experienced gait training.
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22
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Losana-Ferrer A, Manzanas-López S, Cuenca-Martínez F, Paris-Alemany A, La Touche R. Effects of motor imagery and action observation on hand grip strength, electromyographic activity and intramuscular oxygenation in the hand gripping gesture: A randomized controlled trial. Hum Mov Sci 2018; 58:119-131. [PMID: 29408163 DOI: 10.1016/j.humov.2018.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 01/06/2018] [Accepted: 01/21/2018] [Indexed: 01/24/2023]
Abstract
The aim of this study was to evaluate the effects of motor imagery and action observation combined with a hand grip strength program on the forearm muscles. Sixty subjects were selected and randomized into three groups: motor imagery (n = 20), action observation (n = 20), or a control group (n = 20). Outcome measures included hand grip strength, electromyographical activity and intramuscular oxygenation. The hand grip strength significantly increased in the motor imagery (p < .001) and action observation (p < .001) groups compared with the control group, although there were no differences between the both groups (p = .30). In the electromyographical activity, intra-group significant differences were found in motor imagery (p = .002) and action observation (p = .003) groups, although there were no differences between the both groups (p = 1.00) Intramuscular oxygenation results did not show any statistically significant differences between any of the study groups (p > .05). Our results suggest that both motor imagery and action observation training, combined with a hand grip strength program, present a significant strength gain and significant change in the strength and electromyographical activity of the forearm muscles, however no change was found in intramuscular oxygenation.
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Affiliation(s)
- Alejandro Losana-Ferrer
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | - Sergio Manzanas-López
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain
| | - Alba Paris-Alemany
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
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23
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Fu J, Zeng M, Shen F, Cui Y, Zhu M, Gu X, Sun Y. Effects of action observation therapy on upper extremity function, daily activities and motion evoked potential in cerebral infarction patients. Medicine (Baltimore) 2017; 96:e8080. [PMID: 29049194 PMCID: PMC5662360 DOI: 10.1097/md.0000000000008080] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The aim of this study was to explore the effects of action observation therapy on motor function of upper extremity, activities of daily living, and motion evoked potential in cerebral infarction patients. METHOD Cerebral infarction survivors were randomly assigned to an experimental group (28 patients) or a control group (25 patients). The conventional rehabilitation treatments were applied in both groups, but the experimental group received an additional action observation therapy for 8 weeks (6 times per week, 20 minutes per time). Fugl-Meyer assessment (FMA), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), and motor evoked potential (MEP) were used to evaluate the upper limb movement function and daily life activity. RESULTS There were no significant differences between experiment and control group in the indexes, including FMA, WMFT, and MBI scores, before the intervention. However, after 8 weeks treatments, these indexes were improved significantly. MEP latency and center-motion conduction time (CMCT) decreased from 23.82 ± 2.16 and 11.15 ± 1.68 to 22.69 ± 2.11 and 10.12 ± 1.46 ms. MEP amplitude increased from 0.61 ± 0.22 to 1.25 ± 0.38 mV. A remarkable relationship between the evaluations indexes of MEP and FMA was found. CONCLUSIONS Combination of motion observation and traditional upper limb rehabilitation treatment technology can significantly elevate the movement function of cerebral infarction patients in subacute seizure phase with upper limb dysfunction, which expanded the application range of motion observation therapy and provided an effective therapy strategy for upper extremities hemiplegia in stroke patients.
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Affiliation(s)
- Jianming Fu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province
| | - Ming Zeng
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province
| | - Fang Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province
| | - Yao Cui
- Department of Physical Therapy, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Meihong Zhu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province
| | - Xudong Gu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province
| | - Ya Sun
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province
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24
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Gama GL, de Lucena LC, Brasileiro ACDAL, Silva EMGDS, Galvão ÉRVP, Maciel ÁC, Lindquist ARR. Post-stroke hemiparesis: Does chronicity, etiology, and lesion side are associated with gait pattern? Top Stroke Rehabil 2017; 24:388-393. [PMID: 28399777 DOI: 10.1080/10749357.2017.1304865] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Studies that evaluate gait rehabilitation programs for individuals with stroke often consider time since stroke of more than six months. In addition, most of these studies do not use lesion etiology or affected cerebral hemisphere as study factors. However, it is unknown whether these factors are associated with post-stroke motor performance after the spontaneous recovery period. OBJECTIVE To investigate whether time since stroke onset, etiology, and lesion side is associated with spatiotemporal and angular gait parameters of individuals with chronic stroke. METHODS Fifty individuals with chronic hemiparesis (20 women) were evaluated. The sample was stratified according to time since stroke (between 6 and 12 months, between 13 and 36 months, and over 36 months), affected cerebral hemisphere (left or right) and lesion etiology (ischemic and hemorrhagic). The participants were evaluated during overground walking at self-selected gait speed, and spatiotemporal and angular gait parameters were calculated. Results Differences between gait speed, stride length, hip flexion, and knee flexion were observed in subgroups stratified based on lesion etiology. Survivors of a hemorrhagic stroke exhibited more severe gait impairment. Subgroups stratified based on time since stroke only showed intergroup differences for stride length, and subgroups stratified based on affected cerebral hemisphere displayed between-group differences for swing time symmetry ratio. CONCLUSION In order to recruit a more homogeneous sample, more accurate results were obtained and an appropriate rehabilitation program was offered, researchers and clinicians should consider that gait pattern might be associated with time since stroke, affected cerebral hemisphere and lesion etiology.
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Affiliation(s)
- Gabriela Lopes Gama
- a Institute of Physical Activity and Sport Sciences , Cruzeiro do Sul University , São Paulo , Brazil
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25
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Krishnan S, Pappadis MR, Weller SC, Fisher SR, Hay CC, Reistetter TA. Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis. Disabil Rehabil 2017; 40:1401-1409. [PMID: 28320217 DOI: 10.1080/09638288.2017.1297855] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To explore the mobility-related preferences among stroke survivors and caregivers following post-acute rehabilitation at inpatient or skilled nursing facilities. METHODS In this cross-sectional study; semi-structured, qualitative interviews of stroke survivors (n = 24) and informal caregivers (n = 15) were conducted. The participants were recruited from the community. RESULTS Comparative content analysis was used to identify themes by two independent coders. The survivors (68 years) and caregivers (58 years) mentioned mobility-related consequences including inability to walk, balance, drive, and transfer; and increased falls. The survivors (63%) and caregivers (73%) also mentioned the use of assistive devices. The common rehabilitation activities included: walking (62%); followed by standing and mobility; strength and balance; and wheelchair skills. Some stroke survivors were dissatisfied as their rehabilitation was not patient-centered. Frequently mentioned outcome preferences by survivors were ability to walk (88%), move, and balance. They also wanted to acquire assistive devices to move independently. Caregivers were concerned with the survivor's safety and wanted them to drive (53%), prevent falls, have home accommodations, and transfer independently. Caregivers (40%) also expressed the importance of receiving realistic information. CONCLUSIONS This study suggests a need to consider the stroke survivors' and caregivers' mobility outcome preferences to improve the patient-centered rehabilitation care. Implications for Rehabilitation Stroke survivors and caregivers tend to differ in their outcome preferences. Caregivers expressed concern for transfers, driving, fall prevention, home modifications, and wished for realistic information. Incorporating stroke survivors and their families' perspectives during rehabilitation may enhance patient-centered outcomes.
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Affiliation(s)
- Shilpa Krishnan
- a Department of Occupational Therapy , University of Texas Medical Branch , Galveston , TX , USA
| | - Monique R Pappadis
- b Division of Rehabilitation Sciences , University of Texas Medical Branch , Galveston , TX , USA
| | - Susan C Weller
- c Preventive Medicine and Community Health , University of Texas Medical Branch , Galveston , TX , USA
| | - Steve R Fisher
- d Department of Physical Therapy , University of Texas Medical Branch , Galveston , TX , USA
| | - Catherine C Hay
- b Division of Rehabilitation Sciences , University of Texas Medical Branch , Galveston , TX , USA
| | - Timothy A Reistetter
- a Department of Occupational Therapy , University of Texas Medical Branch , Galveston , TX , USA.,b Division of Rehabilitation Sciences , University of Texas Medical Branch , Galveston , TX , USA
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