Sarasso Elisabetta, Gemma Mariano, Agosta Federica, Filippi Massimo, Gatti Roberto
Rehabilitation Department, San Raffaele Scientific Institute, Milan, Italy.
Neuroimaging Research Unit, INSPE, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Arch Physiother. 2015 Dec 2;5:14. doi: 10.1186/s40945-015-0013-x. eCollection 2015.
Following the discovery of Mirror Neuron System (MNS), Action Observation Training (AOT) has become an emerging rehabilitation tool to improve motor functions both in neurologic and orthopedic pathologies. The aim of this study is to present the state of the art on the use of AOT in experimental studies to improve motor function recovery in any disease. The research was performed in PubMed, PEDro, Embase, CINAHL and Cochrane Central Register of Controlled Trials (last search July 2015). Randomized controlled trials (RCTs) that analyse efficacy of AOT for recovery of motor functions, regardless of the kind of disease, were retrieved. The validity of the included studies was assessed using the Cochrane Collaboration tool for evaluating risk of bias. Twenty RCTs were eligible. Four studies showed AOT efficacy in improving upper limb functional recovery in participants with chronic stroke, two studies in sub-acute ones and one in acute ones. Six articles suggested its effectiveness on walking performance in chronic stroke individuals, and three of them also suggested an efficacy in improving balance. The use of AOT was also recommended in individuals with Parkinson's disease to improve autonomy in activities of daily living, to improve spontaneous movement rate of self-paced finger movements and to reduce freezing of gait. Other two studies also indicated that AOT improves upper limb motor function in children with cerebral palsy. The last two studies, showed the efficacy of AOT in improving motor recovery in postsurgical orthopedic participants. Overall methodological quality of the considered studies was medium. The majority of analyzed studies suggest the efficacy of AOT, in addition to conventional physiotherapy, to improve motor function recovery in individuals with neurological and orthopedic diseases. However, the application of AOT is very heterogeneous in terms of diseases and outcome measures assessed, which makes it difficult to reach, to date, any conclusion that might influence clinical practice.
在镜像神经元系统（MNS）被发现之后，动作观察训练（AOT）已成为一种新兴的康复工具，用于改善神经科和骨科疾病中的运动功能。本研究的目的是介绍在实验研究中使用AOT改善任何疾病中运动功能恢复的最新情况。研究在PubMed、PEDro、Embase、CINAHL和Cochrane对照试验中央注册库（最后一次检索时间为2015年7月）中进行。检索了分析AOT对运动功能恢复疗效的随机对照试验（RCT），无论疾病类型如何。使用Cochrane协作工具评估纳入研究的有效性，以评估偏倚风险。20项RCT符合条件。四项研究表明AOT对改善慢性中风参与者的上肢功能恢复有效，两项研究针对亚急性中风参与者，一项针对急性中风参与者。六篇文章表明其对慢性中风个体的步行表现有效，其中三篇还表明对改善平衡有效。帕金森病患者使用AOT也被推荐用于提高日常生活活动的自主性、提高自定节奏手指运动的自发运动速度以及减少步态冻结。另外两项研究还表明AOT可改善脑瘫儿童的上肢运动功能。最后两项研究表明AOT对改善骨科手术后参与者的运动恢复有效。所考虑研究的总体方法学质量为中等。大多数分析研究表明，除了传统物理治疗外，AOT对改善神经科和骨科疾病患者的运动功能恢复有效。然而，AOT在疾病和评估的结局指标方面的应用非常不一致，这使得迄今为止难以得出可能影响临床实践的任何结论。
