• The Journal of Korean Physical Therapy
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• 제29권4호
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• pp.164-168
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• 2017

Purpose: Functional electrical stimulation (FES) is a device that activates the sensorimotor cortex through electrodes attached to the surface of the skin. However, it is difficult to expect positive changes if the recipient is not attentive to the motion. To complement the perceived cognitive limitations of FES, we attempted to investigate the changes of sensorimotor cortex activity by simultaneously providing action observation with FES. Methods: Electroencephalogram was measured in 28 healthy volunteers. Relative band power over the sensorimotor cortex was analyzed and compared in three conditions: during rest, during FES alone, during action observation with FES. Results: The results showed significant differences in each relative band power. Relative alpha power and relative beta power were the lowest by application of FES combined with action observation, while the relative gamma power was the highest. Conclusion: These results suggest that combining FES with observation could be more effective than FES alone in neurorehabilitation.

• The Journal of Korean Physical Therapy
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• 제28권3호
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• pp.176-182
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• 2016

Purpose: To investigate the effect of treadmill training applied simultaneously with gait related action observation on walking ability in chronic stroke patients. Methods: Sixteen chronic stroke patients participated in this study. Participants were randomly allocated into either the treadmill applied simultaneously with action observation training group (TAG) or treadmill applied simultaneously with landscape observation training group (TLG). The participants in both group underwent treadmill training for four weeks (a total of twelve minute, once a day, three times weekly for a four week period). All participants were measured to gait speed (10 m walking test, 10 MWT), gait endurance (6 minute walk distance, 6 MWD), dynamic gait index (DGI). In order to assure the statistical significance of the results, we used for SPSS 15.0 for windows. The Wilcoxon signed ranks test was used to compare pre-test and post-test result, and the Mann-Whitney U-test was employed for comparison between groups. Results: The 10 MWT, 6 MWD, DGI was significantly different between the TAG and the TLG group. Conclusion: According the results of this study, treadmill applied simultaneously with action observation (TAG) is effective intervention for improvement of walking ability in chronic stroke patient.

• 한국산학기술학회논문지
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• 제15권6호
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• pp.3759-3765
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• 2014

본 연구의 목적은 동작관찰훈련이 만성 뇌졸중 환자의 균형능력에 미치는 영향을 알아보고자 실시하였다. 연구기간은 2013년 7월 8일부터 8월 10일까지 수행하였다. 연구대상자들은 무작위로 풍경사진관찰군(n=20)과 동작관찰군(n=20)으로 나누었다. 두 군은 각각 5분 동안 풍경사진 및 균형과 관련된 동작을 동영상으로 관찰하였다. 영상관찰 후, 두 군 모두 10분동안 균형훈련을 받았다. 훈련 세션은 2회 반복하여 하루 30분, 주 3회, 6주 동안 실시하였다. 그 결과, 풍경사진관찰군에 비해 동작관찰군에서 정적 및 동적균형이 유의하게 증가함을 확인할 수 있었다(p<.05). 결론적으로, 동작관찰과 균형훈련의 결합은 만성 뇌졸중 환자의 균형회복에 도움을 줄 것으로 생각된다.

• PNF and Movement
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• 제12권1호
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• pp.19-25
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• 2014

Purpose: To investigate the effect of action observation training on the muscle onset time and symmetrical use of rectus femoris(RF) and gastrocnemius medialis(GCM) during sit-to-stand (STS). Methods: Sixteen patients with stroke entered a single-blind trial and were randomly assigned to the experimental(Action) or control(Landscape) groups. Those in the Action observation group watched video clips showing specific movement and strategies to STS, wheas those in the control group watched video clips of static pictures showing differnet landscapes. All patients was measured the EMG data in the STS on the affected side and unaffected side. The EMG data were collected from RF and GCM while performing the STS task. The EMG onset time and onset time ratio for the RF and GCM were calculated by dividing the EMG onset time of RF and GCM action on the affected side by these on the unaffected side. Results: Onset time of affected side RF, GCM was significantly faster action observation training group than control group(p<.05). But interventions before and after the symmetry did not show a significant increase. Conclusion: There findings suggest that action observation training has a positive effect on the muscle onset time shortened during STS tasks.

• The Journal of Korean Physical Therapy
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• 제29권5호
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• pp.246-254
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• 2017

Purpose: Previous studies have reported that action observation training has beneficial effects on enhancing the motor task, such as balance and gait functions. On the other hand, there have been few studies combined with action observation training and auditory feedback. The purpose of this study was to determine the effects of action observation training with auditory feedback on the gait function in stroke patients with hemiparesis Methods: A total of 24 inpatients with post-stroke hemiparesis were assigned randomly to either an experimental group 1 (EG 1, n=8), experiment group 2 (EG 2, n=8), control group (CG, n=8, EG 1). The EG 2 and CG watched video clip demonstrating three functional walking tasks with auditory feedback, without auditory feedback, and showing a landscape image, respectively. The exercise program consisted of 30 minutes, five times a week, for four weeks. The participants were measured to 10MWT (10 m walk test), 6MWT (6 minutes walking distance test), TUG (timed up and go test), DGI (dynamic gait index), time and steps of F8WT (figure-of-8 walk test). Results: In the intra-group comparison after the intervention, EG 1 and EG 2 showed a significantly different gait function (10MWT, 6MWT, DGI, TUG, F8WT) (p<0.05). In the inter-group comparison after intervention, EG 1 showed significant improvements in the entire gait parameters and EG 2 only showed significant improvement in DGI and TUG compared to CG (p<0.05). Conclusion: These findings show that action observation training with auditory feedback may be used beneficially for improving the gait function of stroke patients with hemiparesis.

• 한국산학기술학회논문지
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• 제13권8호
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• pp.3610-3617
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• 2012

본 연구는 활동관찰 훈련이 편마비 환자의 보행에 미치는 영향에 대하여 평가하였다. 본 연구에 참여자는 실험군 10명과 대조군 10명으로 무작위로 배정되었다. 두 그룹 모두 중추신경계 발달 치료를 6주 동안 1회당 1시간씩 주당 6회 훈련을 받았다. 실험군은 활동 관찰훈련을 6주 동안 1회당 10분씩 주당 3회를 중추신경계 발달치료와 병행하여 훈련받았다. 실험군과 대조군은 보행속도, 마비측 보장, 비마비측 보장, 마비측 활보장, 비마비측 활보장, 두발지지기, 분속수, 일어나 걸어가기 검사를 평가하였다. 활동관찰 훈련을 실시한 그룹에서 편마비 환자의 보행속도, 마비측 보폭, 마비측 활보장, 분속수, 일어나 걸어가기 검사에서 유의하게 향상되었다. 위의 결과를 통하여 활동관찰 훈련은 편마비 환자의 보행 능력을 향상하는 데 효과가 있음을 확인하였다. 따라서 활동관찰 훈련 결과는 편마비 환자들에게 유용하고 적절한 훈련으로 제안할 수 있을 것이다.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.135-139
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• 2015

Purpose: The aim of this study was to compare EEG topographical maps in patients with chronic stroke after action observation physical training. Methods: Ten subjects were recruited from a medical hospital. Participants observed the action of transferring a small block from one box to another for 6 sessions of 1 minute each, and then performed the observed action for 3 minutes, 6 times. An EEG-based brain mapping system with 32 scalp sites was used to determine cortical reorganization in the regions of interest (ROIs) during observation of movement. The EEG-based brain mapping was comparison in within-group before and after training. ROIs included the primary sensorimotor cortex, premotor cortex, superior parietal lobule, inferior parietal lobule, superior temporal lobe, and visual cortex. EEG data were analyzed with an average log ratio in order to control the variability of the absolute mu power. The mu power log ratio was in within-group comparison with paired t-tests. Results: Participants showed activation prior to the intervention in all of the cerebral cortex, whereas the inferior frontal gyrus, superior frontal gyrus, precentral gyrus, and inferior parietal cortex were selectively activated after the training. There were no differences in mu power between each session. Conclusion: These findings suggest that action observation physical training contributes to attaining brain reorganization and improving brain functionality, as part of rehabilitation and intervention programs.

• PNF and Movement
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• 제13권4호
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• pp.175-180
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• 2015

Purpose: This study aimed to examine the effects of mirror-neuron-system-based action observation physical training on improvements in upper extremity functions and daily living activities in chronic stroke patients. Methods: Ten chronic stroke patients were randomly selected. As a therapeutic intervention, along with conventional occupational therapy, the patients engaged in action observation physical training through repeated imitation practices after they viewed a video. The therapeutic intervention was implemented for 20 minutes, three times each week for eight weeks. A Manual Function Test (MFT) was conducted to compare upper extremity functions before and after the therapeutic intervention, and the Modified Barthel Index (MBI) was used to compare the ability to perform daily living activities. Results: Significant improvements in upper extremity motor functions and the ability to perform daily living activities were shown after the intervention. The subjects' left upper extremity motor functions and ability to perform daily living activities showed significant improvement after the intervention. Conclusion: The study's results indicate that action observation physical training based on the mirror neuron system improves chronic stroke patients' upper extremity motor functions and their ability to perform daily living activities. Therefore, action observation training has positive effects on the functional recovery of chronic stroke patients.

• 대한물리의학회지
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• 제11권1호
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• pp.133-140
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• 2016

PURPOSE: This study's aim was to investigate the effects of an action observational training in subactue stroke patients with moderate impairment. METHODS: 22 participants (men=13, women=9) with hemiparesis were randomly assigned to action observation training group or task-oriented training group. Patients in both group underwent a patient-specific multidisciplinary rehabilitation program. Participants in the action observation group (mean age, $62.78{\pm}9.85$) were asked to watch the video scene, in the knowledge that they would then attempt to perform the same movement task after watching. The control group (mean age, $61.49{\pm}8.64$) practiced the same tasks, without watching the video. To evaluate upper limb function, the upper extremity part of the Fugl-Meyer Assessment upper extremity and the Box and Block Test were used. The modified Barthel index was used to assess ADLs, and the modified Ashworth scale were used to assess spasticity in the upper extremity. RESULTS: The action observational training group exhibited greater changes in the Fugl-Meyer assessment upper extremity (P<0.05; 95% CI, 0.929 - 6.403), the Box and Block test (P<0.05; 95% CI, 0.086 - 5.913), and the modified Barthel index (P<0.01; 95% CI, 2.483 - 12.627) between groups. And the modified Ashworth scale (P>0.05; 95% CI, -0.402 to 0.624) did not show significantly different between groups. CONCLUSION: These findings suggest that action observational training may be more helpful to improve upper-extremity function than physical training only in subactue patients with moderate impairment after stroke.

• PNF and Movement
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• 제14권3호
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• pp.209-217
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• 2016

Purpose: Treatments using a mirror neuron system, such as 3D virtual reality therapy, are used in stroke rehabilitation, but they need to be constructed according to a detailed procedure. The aims of this study were to analyze electroencephalograms (EEG) during relaxation and action while observing first person perspective (1AE) and third person perspective (3AE) videos of the right hand for 20's. Methods: Thirty participants (Male=4, Female=26) were recruited for this study. Participants were selected by a vividness of movement imagery questionnaire (VMIQ). EEG was measured during relaxxation and during action with 1AE and 3AE videos, focusing on the supination and pronation actions of participants' right hands. An absolute mu rhythm, a relatively high alpha power, and a relative beta power were identified. In each group, one-way repeated measures ANOVA was used for statistical analysis. Results: Measurement of absolute mu rhythms was significantly suppressed for both 1AE and 3AE compared with relaxation in C3 and C4 regions. High alpha wave measurements were significantly suppressed for both 1AE and 3AE in all regions, while beta wave measurements were significantly increased only for 3AE in F3 and F4 regions. Conclusion: Based on this study, we suggest that the mirror neuron system is activated during actions accompanied by action observation, especially actions with 3AE video observation, which can be a great therapeutic mathod in stroke rehabilitation.