Top-down and bottom-up stimulation techniques combined with action observation treatment in stroke rehabilitation: a perspective

How many hundreds of hours of action observation videos does your hospital have for you? NONE? THEN YOUR HOSPITAL IS TOTALLY FUCKING INCOMPETENT! 

• action observation (123 posts to May 2011)

 

Top-down and bottom-up stimulation techniques combined with action observation treatment in stroke rehabilitation: a perspective

Fengxue Qi¹, Michael A. Nitsche², Xiping Ren³, Duanwei Wang^4* and Lijuan Wang^{5, 6*}

• ¹Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, China
• ²Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Germany
• ³College of Physical Education and Health Sciences, Zhejiang Normal University, China
• ⁴Shandong Mental Health Center, Shandong University, China
• ⁵Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, China
• ⁶School of Sports Medicine and Rehabilitation, Beijing Sport University, China

The final, formatted version of the article will be published soon.

Stroke is a central nervous system disease that causes structural lesions and functional impairments of the brain, resulting in varying types, and degrees of dysfunction. The bimodal balance-recovery model (interhemispheric competition model and vicariation model) has been proposed as the mechanism of functional recovery after a stroke. We analyzed how combinations of motor observation treatment approaches, transcranial electrical (TES) or magnetic (TMS) stimulation and peripheral electrical (PES) or magnetic (PMS) stimulation techniques can be taken as accessorial physical therapy methods on symptom reduction of stroke patients. We suggest that top-down and bottom-up stimulation techniques combined with action observation treatment synergistically might develop into valuable physical therapy strategies in neurorehabilitation after stroke. We explored how TES or TMS intervention over the contralesional hemisphere or the lesioned hemisphere combined with PES or PMS of the paretic limbs during motor observation followed by action execution have super-additive effects to potentiate the effect of conventional treatment in stroke patients. The proposed paradigm could be an innovative and adjunctive approach to potentiate the effect of conventional rehabilitation treatment, especially for those patients with severe motor deficits.

Keywords: transcranial direct current stimulation, Transcranial random noise stimulation, transcranial alternating current stimulation, Transcranial Magnetic Stimulation, Peripheral electrical stimulation, Peripheral magnetic stimulation, action observation

Received: 03 Feb 2023; Accepted: 26 Jun 2023.

Copyright: © 2023 Qi, Nitsche, Ren, Wang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mx. Duanwei Wang, Shandong Mental Health Center, Shandong University, Shandong, China
Mx. Lijuan Wang, Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China

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