Action Observation Treatment (AOB) as a Means of Physical Rehabilitation

AOB may be defined as when the observation of actions performed by others activate in an observer the same neural structures  as when he/she actually performs the same actions.

There is evidence  that the observation of actions activates the same cortical motor areas that are involved in the actual  performance of the observed actions. The neural substrate for this is the mirror neuron system. We capture this neuronal system and then re-enact the stored motor representations as a means for rehabilitating motor control. This may be called motor imagery.

In a study employing AOB eight stroke patients with moderate, chronic motor deficit of the upper limb  participated. A significant improvement of motor functions during a 4-week treatment, as compared to the stable pre-treatment baseline, and compared with a control group was found. The improvement lasted for  8 weeks after the end of the intervention.

Physical rehabilitation, for a large part may be seen as a learning process where old skills have to be re-acquired and new ones have to be learned on the basis of practice. Active exercising creates a flow of sensory  information. It is known that motor recovery and motor learning have many aspects in common. Both are largely based on response-produced sensory information.  Numerous studies have indicated that motor imagery may result in the same plastic changes in the motor system as actual physical practice. Motor imagery is the mental execution of a movement without any overt movement or without any peripheral (muscle) activation. It has been shown that motor imagery leads to the activation of the same brain areas as actual movement. Therefore motor imagery may play  an important  role in neurological rehabilitation. Furthermore, the observation of a movement may play a similar role in learning movement.  The use of motor imagery in neurological rehabilitation may have a value even if it’s on  theoretical grounds and on the basis of the results of  studies with healthy subjects.

For actual physical therapy solutions for stroke patient rehabilitation the TUTOR system is one of the most effective products available. The TUTOR system, consisting of the HANDTUTOR, ARMTUTOR, LEGTUTOR and 3DTUTOR, are ergonomic gloves and braces with speed and position sensors  that are placed on affected parts of the body. Specialized powerful software is used to allow the patient to exercise his affected limb. The information is then recorded and evaluated by the physical therapist who then designs a customized exercise plan for that patient. The TUTORs are currently in use in leading U.S. and European hospitals and clinics and are fully certified by the FDA and CE. The patient can avail himself of the TUTOR system at home through the use of telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.


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