Objective To investigate the effects of action observation therapy(AOT) based on mirror neuron theory on the balance and walking ability of children with cerebral palsy(CP), so as to provide clinical basis for improving the motor function of the lower extremities in CP children. Methods A total of 99 CP children who were treated in Xiangya Boai Rehabilitation Hospital from October 2021 to February 2022 were randomly divided into AOT group (n=50) and control group (n=49) according to the digital table method. Both groups of CP children received routine rehabilitation therapy. Additionally, children in AOT group received AOT for 40 minutes a day, where they watched the video with sports content first, and then performed the action. Children in the control group received therapy 40 minutes a day, watched the animated videos irrelevant to the content of the movement first, and then performed the same functional actions with the AOT group. Both groups received treatment for 12 weeks, once a day, 5 times per week. The balance function, walking ability and gross motor function were assessed before treatment and after 12 weeks of treatment using the Pediatric Balance Scale (PBS), 10-meter Maximum Walking Speed (10 m MWS) and Gross Motor Function Methods (GMFM). Results After 12 weeks of treatment, the scores of PBS, 10 m MWS, GMFM-D area and E area in the two groups were significantly higher than those before treatment (AOT group:t=34.156, 40.379, 18.569, 28.856; control group:t=14.342, 31.533, 11.058, 16.479, P<0.001). The scores of PBS (40.76±6.38), 10 m MWS(20.30±3.06), GMFM-D area (33.52±5.88) and GMFM-E area (46.44±13.37) in the AOT group were significantly higher than those in the control group after 12 weeks of treatment (t=2.245, 2.573, 2.345, 2.101, P<0.05). Conclusions Action observation therapy based on mirror neuron theory can effectively improve the balance function and walking ability of children with cerebral palsy,which is worthy of application in clinic practice.
Key words
mirror neuron system /
action observation training /
cerebral palsy /
walking ability
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References
[1] 中国脑性瘫痪康复指南编委会.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志,2015,30(1):749-754.
Chinese Rehabilitation Guidelines for Cerebral Palsy Editorial Board.Chinese rehabilitation guidelines for cerebral palsy (2015 edition):Part 1[J].Chin J Rehabil Med,2015,30(1):749-754.
[2] 赵晓科,张跃,杜森杰,等.基于体感游戏实现的动作观察训练对痉挛型脑瘫儿童运动功能的影响[J].中华物理医学与康复杂志,2018,40(12):916-918.
Zhao XK,Zhang Y,Du SJ,et al.Effects of action observation training based on somatosensory games on motor function of children with spastic cerebral palsy[J].Chin J Phys Med Rehabil,2018,40(12):916-918.
[3] Peng TH,Zhu JD,Chen CC,et al.Action observation therapy for improving arm function, walking ability, and daily activity performance after stroke:A systematic review and meta-analysis[J].Clin Rehabil,2019,33(8):1277-1285.
[4] Ryan D,Fullen B,Rio E,et al.Effect of action observation therapy in the rehabilitation of neurologic and musculoskeletal conditions:A systematic review[J].Arch Rehabil Res Clin Transl,2021,3(1):100106.
[5] Buccino G,Molinaro A,Ambrosi C,et al.Action observation treatment improves upper limb motor functions in children with cerebral palsy:A combined clinical and brain imaging study[J].Neural Plast,2018:4843985.
[6] Alamer AD.Effectiveness of action observation training on upper limb motor function in children with hemiplegic cerebral palsy:A systematic review of randomized controlled trials[J].Pediatric Health Med Ther,2020,11:335-346.
[7] 周文颖,范桃林,胡碧浓,等.悬吊运动训练对痉挛型双瘫患儿选择性脊神经后根切断术后步行能力的影响[J].中国儿童保健杂志,2021,29(4):458-462.
ZhouWY,Fan TL,Hu BN,et al.Study on the effect of sling exercise training on the walking ability of children with spastic diplegia cerebral palsy after selective posterior rhizotomy[J].Chin J Child Health Care,2021, 29(4):458-462.
[8] 史惟.复旦中文版脑瘫粗大运动功能测试量表项目难度改良及反应度和精确度研究[J].中国循证儿科杂志,2018,13(2):81-87.
Shi W.The study of items difficulty order, responsiveness and precision of Fudan Chinese Version Gross Motor Function Measure[J].Chin J Evid Based Pediatr,2018,13(2):81-87.
[9] Buccino G.Action observation treatment:A novel tool in neurorehabilitation[J].Philos Trans R Soc Lond B Biol Sci,2014,369(1644):20130185.
[10] Sarasso E,Gemma M,Agosta F,et al.Action observation training to improve motor function recovery:A systematic review[J].Arch Physiother,2015,5:14.
[11] Buchignani B,Beani E,Pomeroy V,et al.Action observation training for rehabilitation in brain injuries:A systematic review and meta-analysis[J].BMC Neurol,2019,19(1):344.
[12] 张广宇,刘国庆,朱登纳,等.2020年Current Neurology and Neuroscience Reports《2019年证据交通信号灯状况:儿童脑性瘫痪防治干预措施的系统评价》中国专家解读[J].中国当代儿科杂志,2020,35(6):439-445.
Zhang GY,Liu GQ,Zhu DN,et al.Interpretation of state of the evidence traffic lights 2019:Systematic review of interventions for preventing and treating children with cerebral palsy published by Current Neurology and Neuroscience Reports in 2020[J].Chin J Practi Ped,2020,35(6):439-445.
[13] Naglaa A,Samar T,Menna M,et al.Effect of action observation therapy on motor function in children with cerebral palsy:A systematic review of randomized controlled trials with meta-analysis[J].Clin Rehabil,2020,35(1):51-63.
[14] Simon-Martinez C,Mailleux L,Hoskens J,et al.Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy:Clinical effects and influencing factors of treatment response[J].Ther Adv Neurol Disord,2020,13:1756286419898065.
[15] Youngmin J,Eun-Jung C,Hye-Lim C,et al.Effects of whole-body vibration combined with action observation on gross motor function, balance,and gait in children with spastic cerebral palsy:A preliminary study[J].J Exerc Rehabil,2020,16(3):249-257.
[16] Rossi F,Savi F,Prestia A,et al.Combining action observation treatment with a brain-computer interface system:Perspectives on neurorehabilitation[J].Sensors (Basel),2021,21(24):8504.
[17] Anna M,Serena M,Federica P,et al. Action observation treatment in a tele-rehabilitation setting:A pilot study in children with cerebral palsy[J].Disabil Rehabil,2020,44(7):1107-1112.
[18] Elena B,Valentina M,Adriano F,et al.Feasibility of a home-based action observation training for children with unilateral cerebral palsy:An explorative study[J].Front Neurol,2020,11:16.
[19] Carson HJ,Collins DJ.Commentary:Motor imagery during action observation:A brief review of evidence, theory and future research opportunities[J].Front Hum Neurosci,2017,11:25.
[20] Kim DH.Comparison of short-time and long-time action observation training (AOT) on upper limb function in children with cerebral palsy[J].Physiother Pract Res,2020,41(1):51-58.
[21] Lee HJ, Kim YM, Lee DK. The effects of action observation training and mirror therapy on gait and balance in stroke patients[J].J Phys Ther Sci,2017,29(3):523-526.
[22] Jeong Y,Lee B.Effect of Action observation training on spasticity,gross motor function,and balance in children with diplegia cerebral palsy[J].Children (Basel),2020,7(6):64.
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