Action observation treatment: a novel tool in neurorehabilitation

Abstract

This review focuses on a novel rehabilitation approach known as action observation treatment (AOT). It is now a well-accepted notion in neurophysiology that the observation of actions performed by others activates in the perceiver the same neural structures responsible for the actual execution of those same actions. Areas endowed with this action observation-action execution matching mechanism are defined as the mirror neuron system. AOT exploits this neurophysiological mechanism for the recovery of motor impairment. During one typical session, patients observe a daily action and afterwards execute it in context. So far, this approach has been successfully applied in the rehabilitation of upper limb motor functions in chronic stroke patients, in motor recovery of Parkinson's disease patients, including those presenting with freezing of gait, and in children with cerebral palsy. Interestingly, this approach also improved lower limb motor functions in post-surgical orthopaedic patients. AOT is well grounded in basic neuroscience, thus representing a valid model of translational medicine in the field of neurorehabilitation. Moreover, the results concerning its effectiveness have been collected in randomized controlled studies, thus being an example of evidence-based clinical practice.

Motor Imagery and Action Observation as Effective Tools for Physical Therapy

“…As described above, motor imagery is influenced by the environment, personal imaging ability, and mental effort. In contrast, action observation is easier to apply, despite activation of the same neural network as motor imagery [43]. In addition, Conson et al revealed that action observation had an effect of promoting motor imagery [44].…”

Understanding Neural Mechanisms of Action Observation for Improving Human Motor Skill Acquisition

“…Motor imagery is influenced by the environment and personal imaging ability and requires mental effort. In contrast, action observation is easier to apply than motor imagery, despite targeting activation of the same neural network as motor imagery [35]. We have also reported that the left sensorimotor and parietal areas of the high-motor learning group showed a greater decrease in the alpha-2 and beta-2 rhythms than those of the lowmotor learning group during observation and execution.…”

The Study of Action Observation Therapy in Neurological Diseases: A Few Technical Considerations

“…Most of the actions that have been employed in AOT studies consist of upper limb transitive actions (i.e., actions with object interaction, e.g., using a pencil). These are usually daily actions that have been selected on the basis of their ecological value [27]. This kind of action has been shown to have increased MNS activity in neuroimaging studies [15,28] and corticospinal facilitation in transcranial magnetic stimulation (TMS) [29,30].…”