Abdullahi Auwal, Wong Thomson W L, Ng Shamay S M
Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Brain Sci. 2022 Sep 28;12(10):1311. doi: 10.3390/brainsci12101311.
Rehabilitation of severe impairment in motor function following stroke is very challenging. This is because one of the driving forces for recovery of motor function is tasks practice, something this category of patients cannot voluntarily perform. However, it has now been shown that tasks practice can equally be carried out cognitively and through observation of another person's practice, using techniques known as mental practice and tasks observation, respectively. Mental practice and tasks observation are believed to activate networks of neurons in the brain known as mirror neurons and mentalizing systems to induce recovery. The effectiveness of these techniques has, however, limited evidence at the moment. One possible explanation for this could be the nature of the protocols of these techniques, especially as regards to the intensity of practice. This article proposes ways the potentials of the mirror neurons and mentalizing systems can be harnessed to optimize recovery of severe impairment in motor function using mental practice and tasks observation. The article suggests, among other ways, protocols where tasks observation or mirror therapy are carried out first, and are then followed by mental practice, increasing the number of times the tasks are observed or mentalized, observation of significant others performing the tasks and mental practice of very familiar tasks.
中风后严重运动功能障碍的康复极具挑战性。这是因为运动功能恢复的驱动力之一是任务练习，而这类患者无法自主进行任务练习。然而，现已表明，任务练习同样可以通过认知方式以及观察他人的练习来进行，分别使用被称为心理练习和任务观察的技术。心理练习和任务观察被认为会激活大脑中被称为镜像神经元和心理化系统的神经元网络以促进恢复。然而，目前这些技术的有效性证据有限。对此的一种可能解释可能是这些技术方案的性质，特别是在练习强度方面。本文提出了利用镜像神经元和心理化系统的潜力，通过心理练习和任务观察来优化严重运动功能障碍恢复的方法。文章建议，除其他方法外，可采用先进行任务观察或镜像治疗，然后进行心理练习的方案，增加观察或心理化任务的次数，观察重要他人执行任务以及对非常熟悉的任务进行心理练习。
