The Effects Of Action Observation Therapy On Motor Function Of Upper-extremity In Patients With Ischemic Stroke

Objective To explore the effects of action observation therapy on the motor function of upper-extremity in patients with ischemic stroke, and to investigate the effects of action observation therapy on motor cortex by functional magnetic resonance imaging(fMRI).Methods Forty patients with ischemic stroke were randomly assigned to an observational group(20 cases) or a control group(20 cases). Both groups received conventional rehabilitation,for example,training in the physical therapy、occupational therapy.The observational group also received action observation therapy for 8 weeks,twenty minutes per time,two times per day,5 days per week. Both groups were assessed by the Fugl-Meyer assessment(FMA) and the Barthel index(BI) before treatment,and then again after 8 weeks of treatment. Both groups were assessed by functional magnetic resonance imaging before treatment.Followed up for 2 months, nine patients who continued to do action observation training for two months after discharge were assessed by functional magnetic resonance imaging(fMRI).Results② The average FMA scores at the 8th week(28.00±7.89) in the observational group had increased significantly compared with the pre-treatment assessment. The control groups FMA score at the 8th week(21.95±5.99) had also increased significantly compared with pre-treament assessment.② The average BI scores of both groups had increased significantly at 8th week compared with each group’s pre-treatment assessment.③ At the 8th week the increase in the average FMA score of the observational group was significantly better than that of the control group.But there was no significant difference in the increases in BI score between the two groups after 8 weeks of treatment.④ Brain functional magnetic resonance imaging(fMRI) showed that there was a significant rise in activity in the bilateral precentral gyrus,parietal lobe and the supplementary motor area (SMA).Conclusion Action observation therapy could improve the upper extremity motor function and activities of daily living in patients with ischemic stroke, and cause changes in the excitability of cerebral motor cortex.