This Article Full Text Full Text (PDF) All Versions of this Article: 39/6/1814    most recent STROKEAHA.107.508184v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Celnik, P. Articles by Cohen, L. G. Search for Related Content PubMed PubMed Citation Articles by Celnik, P. Articles by Cohen, L. G. Related Collections Exercise/exercise testing/rehabilitation Behavioral Changes and Stroke Rehabilitation, Stroke

(Stroke. 2008;39:1814.)
© 2008 American Heart Association, Inc.

Original Contributions

Effects of Action Observation on Physical Training After Stroke

Pablo Celnik, MD; Brian Webster, BA; Davis M. Glasser, BS Leonardo G. Cohen, MD

From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic (P.C., B.W., D.M.G., L.G.C.), NINDS, NIH, Bethesda, Md; and the Department of Physical Medicine and Rehabilitation, and Department of Neurology (P.C.), Johns Hopkins University, Baltimore, Md.

Correspondence to Pablo Celnik, MD, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287. E-mail pcelnik{at}jhmi.edu

Background and Purpose— In healthy humans, observation of another individual performing a motor training task (action observation [AO]) facilitates, in the observer, the effects of physical training (PT) on motor memory formation. It is not known whether this facilitatory process, of potential value for neurorehabilitation, occurs after stroke.

Methods— Eight chronic stroke patients completed this crossover-randomized investigation. A transcranial magnetic stimulation protocol that tests formation of motor memories was used to determine the effects of PT alone and in combination with AO in 2 different forms: congruent (PT+AO_congruent) and incongruent (PT+AO_incongruent) to the practiced task.

Results— The magnitude of motor memory formation was larger with PT+AO_congruent than with PT alone or PT+AO_incongruent. This effect was associated with a differential corticomotor excitability change in the muscles acting as agonist and antagonist of the trained/observed movements.

Conclusions— These results indicate that congruent AO in association with physical training can enhance the effects of motor training after stroke.

Key Words: stroke • action observation • mirror neurons system • rehabilitation