THE EFFECTS OF ACTION OBSERVATION AND MOTOR TRAINING ON FUNCTIONAL RELEVANT TASKS IN CHRONIC STROKE PATIENTS

Start guessing how this was accomplished because you will never see a protocol on this while you are alive.  Maybe 50 years from now when survivors run everything.  Whatever the hell motor training is?

THE EFFECTS OF ACTION OBSERVATION AND MOTOR TRAINING ON FUNCTIONAL RELEVANT TASKS IN CHRONIC STROKE PATIENTS

Jeffrey R. Willis, PhD; Pablo Celnik, MD
Objective:
 Despite motor rehabilitation, a large proportion of stroke patients remain with impaired motor function. One strategy that could alter this limitation is the introduction of action observation (AO) during motor training. In humans, AO results in increased cortical excitability of the primary motor cortex and has been shown to enhance the effects of training on motor memory formation in healthy and stroke patients. Within this context, our objective was to evaluate the effect of AO combined with motor training on functional relevant tasks in stroke patients and healthy adults.
 Design:
 We designed a randomized crossover study consisting of three counterbalanced sessions, separated by 10 days,testing: (1) Motor Training alone (MT); (2) Motor Training + AO(MT +AO:CONGRUENT); and (3) Motor Training +Incongruent AO(MT + AO:INCONGRUENT). To date, 11 subjects have been enrolled. In each session, subjects trained the Jebsen Taylor Test (JTT), a task that resembles ADLs. We assessed the time to complete the JTT at three time periods (pre intervention, post intervention, 24hours post intervention)and compared reductions in JTT time at 1-hour post intervention and24-hours post intervention relative to preintervention. Statistical analyses were conducted with the Kruskal Wallis test.
 Results:
 Preliminary data suggests that MT + AO:CONGRUENT results in reduction of JTT time, an effect that was stronger 24 hours post intervention. Both MT and MT + AO:INCONGRUENT also showed a tendency to reduce JTT time. Across all interventions, stroke subjects tended to make greater reductions in JTT time relative to healthy subjects, likely due to better performance at baseline in the healthy group.
 Conclusions:
 Preliminary results show that AO combined with MT may lead to improvements in motor function, possibly, via activation of the mirror neuron system. We plan to continue collecting data to determine the relative contribution of introducing AO into training programs. This data is important given the need to improve rehabilitative programs for stroke patients.