Buccino Giovanni
Dipartimento di Scienze Mediche e Chirurgiche, Università Magna Graecia, , 88100 Catanzaro, Italy.
Philos Trans R Soc Lond B Biol Sci. 2014 Apr 28;369(1644):20130185. doi: 10.1098/rstb.2013.0185. Print 2014.
This review focuses on a novel rehabilitation approach known as action observation treatment (AOT). It is now a well-accepted notion in neurophysiology that the observation of actions performed by others activates in the perceiver the same neural structures responsible for the actual execution of those same actions. Areas endowed with this action observation-action execution matching mechanism are defined as the mirror neuron system. AOT exploits this neurophysiological mechanism for the recovery of motor impairment. During one typical session, patients observe a daily action and afterwards execute it in context. So far, this approach has been successfully applied in the rehabilitation of upper limb motor functions in chronic stroke patients, in motor recovery of Parkinson's disease patients, including those presenting with freezing of gait, and in children with cerebral palsy. Interestingly, this approach also improved lower limb motor functions in post-surgical orthopaedic patients. AOT is well grounded in basic neuroscience, thus representing a valid model of translational medicine in the field of neurorehabilitation. Moreover, the results concerning its effectiveness have been collected in randomized controlled studies, thus being an example of evidence-based clinical practice.
本综述聚焦于一种名为动作观察疗法(AOT)的新型康复方法。在神经生理学领域,现在有一个被广泛接受的观点,即观察他人执行的动作会在观察者中激活与实际执行这些相同动作负责的相同神经结构。赋予这种动作观察 - 动作执行匹配机制的区域被定义为镜像神经元系统。AOT利用这种神经生理机制来恢复运动障碍。在一次典型的治疗过程中,患者观察日常动作,然后在实际情境中执行该动作。到目前为止,这种方法已成功应用于慢性中风患者上肢运动功能的康复、帕金森病患者的运动恢复,包括那些出现步态冻结的患者,以及脑瘫儿童。有趣的是,这种方法还改善了骨科手术后患者的下肢运动功能。AOT在基础神经科学方面有充分的依据,因此代表了神经康复领域转化医学的一个有效模型。此外,关于其有效性的结果已在随机对照研究中收集,因此是基于证据的临床实践的一个例子。