on April 10, 2008
Published online before print April 10, 2008, doi: 10.1161/STROKEAHA.107.508184
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Submitted on October 24, 2007
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. * To whom correspondence should be addressed. 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+AOcongruent) and incongruent (PT+AOincongruent) to the practiced task. Results—The magnitude of motor memory formation was larger with PT+AOcongruent than with PT alone or PT+AOincongruent. 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.
Accepted on November 7, 2007
Effects of Action Observation on Physical Training After Stroke
Pablo Celnik MD*;
Key words: stroke • action observation • mirror neurons system • rehabilitation