• Physical Therapy Korea
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• v.22 no.1
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• pp.69-78
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• 2015

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A') was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

• PNF and Movement
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• v.17 no.2
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• pp.245-252
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• 2019

Purpose: The purpose of this study was to determine the effects of action observation training on lower limb muscle activity and dynamic balance in chronic stroke patients. Methods: This study evaluated 20 chronic stroke patients who were divided randomly into a control and an experimental group comprising 10 patients each. Both the experimental group and the control group performed the general exercise therapy provided by the hospital, but the experimental group also performed action observation training. Lower limb muscle activity was measured with a surface electromyograph, and dynamic balance was measured with the Timed Up and Go test and the 10-meter walk test. The paired t-test was used to compare the groups before and after the experiment. Furthermore, the independent t-test was used to assess differences in the degree of change between the two groups before and after the experiment. Results: The within-group comparisons for both the experimental group and the control group showed significant differences in muscle activity and dynamic balance (p<0.05). In a comparison between the groups, the differences in the muscle activity and dynamic balance of the experimental group appeared significant compared with those of the control group (p<0.05). Conclusion: The study results indicate that action observation training is effective in improving the muscle activity and dynamic balance of chronic stroke patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.22 no.2
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• pp.169-179
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• 2015

Purpose: The purpose of this study was to improve the quality of fundamental nursing practice course. Methods: Participants were 132 students who took the fundamental nursing practice course at D university in N city. The study included processes of planning, action, observation, and reflection. Quantitative data were analyzed using SPSS 20.0 program and qualitative data were evaluated through content analysis. Results: The 12-step designing college courses model by Fink was applied in the planning. In the acting stage, the course was conducted according to the instruction in designing the course, students wrote reflective journals and the professor gave feedback to the reflective journal and the class observation journal was used for lessons. In the observation stage, the course evaluation was surveyed and analyzed, evaluations were positive with 47.1% of students positively evaluating the teaching strategy. In the reflecting stage, outcomes in course improvement were reflected on and, the number of students at the lower level-of-achievement decreased. Conclusion: Action research was a useful research method that could capture the quality improvement process in college courses. Expression of effort and passion to improve quality of education through action research in various ways and to share quality improvement strategies for nursing education are important.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.93-102
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• 2016

PURPOSE: The purpose of this study is to evaluate the functional effects of action observation plus functional electrical stimulation (FES) treatment on the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities, and stride lengths of stroke patients. METHODS: The subjects, who were all more than six months post stroke, were randomly divided into two groups of ten each: an experimental group and a control group. TETRAX (Tetrax Interactive Balance System) and GAITRite (GAITRite$^{TM}$ computerized gait analysis system) were measured at baseline, six weeks after treatment. Participants in both the groups received functional electrical stimulation treatment, but the experimental group was provided with additional action observation. Independent t-tests were used to compare the differences between the groups, and repeated measured two-way ANOVA was used to compare the interaction between the groups. RESULTS: The result of the interactions between the groups and the periods showed significant increases in the weight distribution indexes (heel and toe; right and left), stability indexes, gait velocities and stride lengths (p<0.05). However, a comparison between the groups showed no significance in the weight distribution indexes (heel and toe), stability indexes, and stride lengths (p>0.05). CONCLUSION: Action observation plus functional electrical stimulation treatment should be considered as a therapeutic method for physical therapy for stroke patients to improve the weight distribution indexes, stability indexes, gait velocities, and stride lengths.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.119-130
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• 2019

Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.

• Physical Therapy Korea
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• v.27 no.3
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.7-14
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• 2019

PURPOSE: This study examined the effects of observing a self-video or a video of another person performing balance and gait training, followed by actual performance of the observed movements on the balance and walking ability of chronic stroke patients. METHODS: Thirty patients, who had experienced a stroke and were admitted to S rehabilitation hospital for treatment, were selected randomly and divided into three groups with 10 patients each: self-action observation (SAO) group, other-action observation (OAO) group, and treadmill walking training (TWT) group. The training program was conducted five times per week for four weeks. The GAITRite system, 10 m walking test, and timed up and go test were performed to measure the subjects' gait and balance ability. RESULTS: The velocity, cadence, double support, and stride length were increased significantly in the SAO and OAO groups (p<.05) but the T group showed no significant changes; no significant difference was observed among the groups (p >.05). The 10MWT decreased significantly in the OAO group (p<.05), but there were no significant changes in the SAO and T groups, and no significant difference was observed among the groups (p>.05). The TUG decreased significantly in the SAO and OAO groups (p<.05), but there were no significant changes in the T group, and no significant difference was observed among the groups (p>.05). CONCLUSION: The self or other action observation training helps improve the balance and gait ability.

• PNF and Movement
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• v.18 no.1
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• pp.23-34
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• 2020

Purpose: To explore the effects of action observation combined with modified constraint-induced movement therapy on upper-extremity function and the activities of daily living in subacute stroke patients. Methods: Twenty-four subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each). Both groups received therapy based on motor learning concepts, including repetitive and task-specific practice. The experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos unrelated to upper-extremity movement. These programs were performed for 40 minutes a day five times a week for four weeks. Their scores on the Fugl-Meyer assessment of upper extremities (FMA-UE), the action research arm test (ARAT), a motor activity log (amount of use [AOU] and quality of movement [QOM]), and the modified Barthel index (MBI) were recorded. Results: In both groups, all variables were significantly different between the pre-test and post-test periods (p < 0.05). The post-test variables were significantly different within each group (p < 0.05). In the experimental group, the changes between pre-test and post-test scores in the FMA-UE (14.39 ± 4.31 versus 6.31 ± 4.63), the ARAT (16.00 ± 4.73 versus 11.46 ± 3.73), MAL-AOU (1.57 ± 0.15 versus 1.18 ± 0.28), and MBI (27.54 ± 4.65 versus 18.08 ± 8.52) were significantly higher than those of the control group (p < 0.05). Conclusion: These findings suggest that action observation combined with modified constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate impairment.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.13-21
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• 2021

PURPOSE: This study examined the effects of action observational training with acoustic stimulation (AOTA) on the balance and gait ability in stroke patients. METHODS: Forty-five chronic stroke patients were divided into three groups. The AOTA group (n = 15) received training via a video that showed a normal gait with the sound of footsteps. The action observation training (AOT) group (n = 15) received AOT without acoustic stimulation. The control group (n = 15) received physical training. Each intervention was applied once per day, three times per week for six weeks. The participants in the AOTA and AOT groups had five minutes of AOT. The participants in the all group had 20 minutes of physical training. All participants were measured using the Berg Balance Scale, the Timed Up and Go Test, the Functional Reaching Test, 10 Meter Walk Test, six Minute Walk Test, and Dynamic Gait Index. The collected data were analyzed using SPSS version 20.0 for Windows. The between- and within-group comparisons were analyzed using the one-way analysis of variance (ANOVA) test and a paired t-test, respectively. For all statistical analyses, the significance level was set to .05. RESULTS: The one-way ANOVA test identified significant differences among the measurement results of the three groups (p < .05). Post hoc analyses indicated the AOTA group to undergo more significant balance and gait changes than the control group (p < .05). CONCLUSION: The gait and balance abilities could be improved effectively for patients with stroke when action observation training and acoustic stimulation were applied simultaneously.

• Journal of the Korea Convergence Society
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• v.9 no.12
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• pp.123-128
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• 2018

The aim of this study was to determine the effects of the action observation and visual feedback on the alignment, pain and function of forward head posture(FHP) and round shoulder(RS). A total of 24 participants with FHP and RSP were randomly assigned to general exercise(GE, n=8), action observation(AO, n=8), and visual feedback(VF, n=8). All subjects were exercised three times a week for four weeks. The groups were assessed for craniovertebral angle(CVA), round shoulder posture(RSP), visual analog scale(VAS), and neck disability index(NDI) before and after exercise, There was a significant difference in CVA in the GE, AO and RSP, VAS and NDI were significantly different in all groups. AO was more effective than GE, VF for VAS. The results of this study suggest that action observation may be effective to improve the FHP and RS.