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

Abstract

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

Effect of action observation therapy on motor function in children with cerebral palsy: a systematic review of randomized controlled trials with meta-analysis

“…In the Body Structure and Function domain of the International Classification of Functioning, there were multi assessment tools; Grip Strength, 21,22 Electronic Goniometer, 26 Manual Muscle Testing, 22 Modified Ashworth Scale 22 and Modified Tardieu Scale 26 were assessed showed no significant effect to the Action Observation Therapy. While Functional Magnetic Resonance Imaging, 19 Electroencephalography, 25 and The Five Times Sit To Stand Test 23 and some parameters of upper limb kinematic movement analysis 24 showed significant improvement in favour of the Action Observation Therapy. These results led to conflicting evidence regarding the effectiveness of the Action Observation Therapy in the level of the Body Structure and Function domain of the International Classification of Functioning.…”

“…8 The Capacity sub-domain was evaluated by 11 assessment tools through nine studies. 15–19,22,23,25,26…”

“…Four studies 15,17,19,25 were pooled on the Meta-Analysis. While the other two studies 18,22 were excluded from the Meta-Analysis due to the heterogeneity of their control group interventions.…”

“…The Actual Performance sub-domain was assessed by two outcome measurements; the Assisting Hand Assessment scale 17,19,22,25 and the Triaxial accelerometer. 20 The Assisting Hand Questionnaire was measured through five studies.…”

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

“…In adults with stroke, functional improvements were coupled with an enlargement of movement‐related brain regions during object manipulation in fMRI (Ertelt et al., 2007). Thus far, to our knowledge, only two studies (Buccino et al., 2018; Quadrelli et al, 2019) have explored AOT‐related changes in sensory‐motor representation in children with CP, including also those with congenital hemiplegia, using fMRI and EEG, respectively.…”