Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study

Buccino, Giovanni; Molinaro, Anna; Ambrosi, Claudia; Arisi, D.; Mascaro, Lorella; Pinardi, Chiara; Rossi, Andrea; Gasparotti, Roberto; Fazzi, Elisa; Galli, Jessica

doi:10.1155/2018/4843985

Cited by 58 publications

(127 citation statements)

References 35 publications

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“…The same pattern emerges for MUUL scores, where improvements of the quality of upper limb motor functions were induced only by AOT, but not by VOT. These results extend those obtained in previous research (Buccino et al, , ; Sgandurra et al, ). Indeed, MUUL results showed specific functional gain following the intervention, and also met the requirements for an authentic clinical improvement.…”

Section: Discussionsupporting

confidence: 93%

“…Since µ rhythm suppression is related to the activation of the mirror system during observation and performance of goal‐directed actions, the AOT‐induced increase in µ rhythm suppression over C3/C4 can be ascribed to the improved activation of motor areas. This result is in line with findings from fMRI studies in both children with CP (Buccino et al, ) and adult stroke patients (Ertelt et al, ) showing the increased activation of frontal and parietal areas (in particular of the premotor cortex and the superior temporal gyrus) following AOT. Interestingly, despite no significant difference was found between sensorimotor activation recorded over Cz between pre‐ and post‐AOT, we reported a significant absolute activation (i.e., compared to baseline) over Cz at post‐treatment.…”

Section: Discussionsupporting

confidence: 90%

“…A few experimental studies showed promising results with respect to the efficacy of AOT in improving motor planning and execution also in children with CP (Buccino et al, , ; Kirkpatrick, Pearse, James, & Basu, ; Sgandurra et al, ). In Buccino and colleagues' pilot study (), children with unilateral and bilateral CP aged 5–11 years were instructed to observe videos of daily uni‐ and bi‐manual actions and repeatedly reproduce those actions.…”

Section: Introductionmentioning

confidence: 99%

“…However, the neural underpinnings of the AOT still remain to be determined. To date, only one fMRI study has explored the cortical reorganization following the AOT, showing an increased activation of premotor and parietal areas; both areas are involved in motor representation and are included in the human mirror system (Buccino et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Electrophysiological correlates of action observation treatment in children with cerebral palsy: A pilot study

Quadrelli

Anzani²,

Ferri³

et al. 2019

Developmental Neurobiology

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Action Observation Treatment (AOT) has been shown to be effective in the functional recovery of several clinical populations. However, little is known about the neural underpinnings of the clinical efficacy of AOT in children with Cerebral Palsy (CP).Using electroencephalography (EEG), we recorded µ rhythm desynchronization as an index of sensorimotor cortex modulation during a passive action observation task before and after AOT. The relationship between sensorimotor modulation and clinical outcomes was also assessed. Eight children with CP entered the present randomized controlled crossover pilot study in which the experimental AOT preceded or followed a control Videogame Observation Treatment (VOT). Results provide further evidence of the clinical efficacy of AOT for improving hand motor function in CP, as assessed with the Assisting Hand Assessment (AHA) and Melbourne Assessment of Unilateral Upper Limb Function Scale (MUUL). The novel finding is that AOT increases µ rhythm desynchronization at scalp locations corresponding to the hand representation areas. This effect is associated to functional improvement assessed with the MUUL. These preliminary findings, although referred to as a small sample, suggest that AOT may affect upper limb motor recovery in children with CP and modulate the activation of sensorimotor areas, offering a potential neurophysiological correlate to support the clinical utility of AOT. K E Y W O R D Saction observation treatment, cerebral palsy, EEG, mirror neuron system, sensorimotor activation

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Electrophysiological correlates of action observation treatment in children with cerebral palsy: A pilot study

Quadrelli

Anzani²,

Ferri³

et al. 2019

Developmental Neurobiology

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“…The authors concluded that children exploit the mirror mechanism to represent the action goal rather than its kinematics. A recent randomized controlled trial investigating the clinical and brain activity changes induced by AOT in children with CP was able to both confirm the clinical efficacy of AOT on hand motor function, and to show that children treated with AOT had stronger activation in a parieto‐premotor circuit for hand‐object interaction, supporting the notion that AOT is able to shape sensory‐motor brain circuits improving the impaired function.…”

mentioning

confidence: 82%

Efficacy of a home‐based platform for child‐to‐child interaction on hand motor function in unilateral cerebral palsy

Nuara

Avanzini

Rizzolatti

et al. 2019

Develop Med Child Neuro

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Aim To evaluate the feasibility and effectiveness of an action observation treatment (AOT) home‐based platform promoting child‐to‐child interaction to improve hand motor function in unilateral cerebral palsy (CP). Method Twenty children (14 males, six females; mean age 6y 7mo, standard deviation 1y 7mo; range 5y 1mo–10y 6mo) with unilateral CP underwent 20 sessions where they had to observe and then imitate a wizard performing dexterity‐demanding magic tricks; a child‐to‐child live video‐session to practise the same exercise then took place. We assessed hand‐motor skills with the Besta Scale, neurological motor impairment with Fugl‐Meyer Assessment for upper extremity, as well as spasticity, muscle strength, visual analogue scale, and global impression of change 1‐month before (T‐1), at baseline (T0), and at the end of treatment (T1). Results We observed a T0 to T1 improvement in global hand‐motor and bimanual skills, and a significant correlation between motor improvement and difference in hand motor skills relative to the peer (r=–0.519). Interpretation AOT associated with child‐to‐child interaction effectively improves hand motor function in unilateral CP. This improvement is linked to differences in hand motor ability among peers, suggesting that children should observe others with superior motor skills to their own. This study extends traditional AOT toward novel socially‐enriched scenarios, where children might simultaneously be recipients and leaders within a motor learning process. What this paper adds Home‐based action observation treatment (AOT) based on child‐to‐child interaction improves hand motor function in children with unilateral cerebral palsy. Interaction with a more capable peer increases the chances of positive outcome in child‐to‐child AOT.

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Reorganization of action observation and sensory‐motor networks after action observation therapy in children with congenital hemiplegia: A pilot study

Sgandurra

Biagi

Fogassi

et al. 2020

Developmental Neurobiology

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New rehabilitation programs based on action observation therapy (AOT) are effective in improving motor function in children with congenital hemiplegia. In this pilot study we tested the potential effects of AOT on the reorganization of the motor system by functional magnetic resonance imaging (fMRI). As part of a randomized trial, eight subjects (age range: 6.2–14.5 years) with congenital hemiplegia were randomly assigned to an experimental (EG) or control (CG) group. All children underwent a clinical and neurophysiological assessment with Assisting Hand Assessment (AHA), MRI, and fMRI at baseline (T0), 1(T1), and 8(T2) weeks after the end of 3‐week treatment. For the EG, AOT consisted in the observation of uni/bimanual goal‐directed actions followed by their execution. CG watched same‐duration computer games and then performed the same actions in the same order used in the EG. fMRI study was carried out using two different paradigms, for exploring sensory‐motor network (SMN) localization and action observation network (AON). The pattern of brain activation was generally similar between T0 and T1 for both groups, while it was more widespread at T2, compared to T0 and T1, in the EG. This enlargement was coupled with functional improvement at AHA. Single‐subject analysis shows a reduction of lateralization indexes both for the AON and the SMN. This pilot study, despite the small sample, showed the fMRI feasibility for providing relevant biomarkers of brain plasticity for monitoring the AOT response in children with congenital hemiplegia. The study was registered at http://www.clinicaltrials.gov (identifier NCT01016496).

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Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study

Cited by 58 publications

References 35 publications

Electrophysiological correlates of action observation treatment in children with cerebral palsy: A pilot study

Electrophysiological correlates of action observation treatment in children with cerebral palsy: A pilot study

Efficacy of a home‐based platform for child‐to‐child interaction on hand motor function in unilateral cerebral palsy

Reorganization of action observation and sensory‐motor networks after action observation therapy in children with congenital hemiplegia: A pilot study

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