Motor Imagery during Action Observation: A Brief Review of Evidence, Theory and Future Research Opportunities

Pretty much worthless because neither MI or AO has publicly available stroke protocols and this follows the same failure model by not creating a stroke protocol either. A great stroke association president would make sure EVERY piece of stroke research creates a stroke protocol out of it. The point of stroke research is to help stroke patients. No fucking clue what the point of this research was for.
http://journal.frontiersin.org/article/10.3389/fnins.2016.00514/full?

Daniel L. Eaves^1*, Martin Riach², Paul S. Holmes² and David J. Wright^2*

• ¹Sport and Exercise Science Section, Teesside University, Middlesbrough, UK
• ²Research Centre for Health, Exercise and Active Living, Manchester Metropolitan University, Crewe, UK

Motor imagery (MI) and action observation (AO) have traditionally been viewed as two separate techniques, which can both be used alongside physical practice to enhance motor learning and rehabilitation. Their independent use has largely been shown to be effective, and there is clear evidence that the two processes can elicit similar activity in the motor system. Building on these well-established findings, research has now turned to investigate the effects of their combined use. In this article, we first review the available neurophysiological and behavioral evidence for the effects of combined action observation and motor imagery (AO+MI) on motor processes. We next describe a conceptual framework for their combined use, and then discuss several areas for future research into AO+MI processes. In this review, we advocate a more integrated approach to AO+MI techniques than has previously been adopted by movement scientists and practitioners alike. We hope that this early review of an emergent body of research, along with a related set of research questions, can inspire new work in this area. We are optimistic that future research will further confirm if, how, and when this combined approach to AO+MI can be more effective in motor learning and rehabilitation settings, relative to the more traditional application of MI or AO independently.

Introduction

Motor imagery (MI) and action observation (AO) can be regarded as two forms of motor simulation, which activate the motor system in the absence of motor execution (Jeannerod, 2001, 2006). MI is a type of mental practice involving the internal generation of visual and kinesthetic aspects of movement, and a large body of research has recommended that practitioners working in motor learning and rehabilitation settings should use MI to improve motor abilities (see Schuster et al., 2011). This can either be as an accompaniment to physical practice to improve behavioral outcomes (e.g., Rozand et al., 2014; Di Rienzo et al., 2015; Ingram et al., 2016), or as a replacement when movement is restricted due to either neurological impairment or injury (e.g., Szameitat et al., 2012; Hoyek et al., 2014; Mateo et al., 2015). It is also well-documented that AO evokes an internal motor representation of the observed movement (also termed “motor resonance”; see Rizzolatti and Sinigaglia, 2010). Consequently, AO has been recommended as a treatment in neurorehabilitation (Buccino, 2014). It also remains a popular and effective tool for enhancing motor learning (see Ste-Marie et al., 2012).

In terms of the associated neural substrates, MI and AO involve motor and motor-related brain areas, which overlap extensively both with one another, and with the regions involved in motor execution (see Grèzes and Decety, 2001; Caspers et al., 2010; Hétu et al., 2013). Although distinct brain structures are identifiable for AO, MI and execution individually (Filimon et al., 2007, 2015; Munzert et al., 2008; Lorey et al., 2013), the case for using MI and AO in motor learning and rehabilitation has been largely predicated on the degree of neural overlap shared with motor execution. It is important to note, however, that while the majority of evidence supports the effectiveness of MI and AO as independent instruction techniques, there is evidence to the contrary (see Braun et al., 2013; Gatti et al., 2013; Sarasso et al., 2015). Furthermore, it is difficult to draw clear conclusions on the mixed results provided across studies that have compared the potential advantages of motor imagery vs. action observation, both on motor function and neural processes (e.g., Porro et al., 2007; Filimon et al., 2007, 2015; Szameitat et al., 2012; Gatti et al., 2013; Gonzalez-Rosa et al., 2015; Helm et al., 2015).