Action observation therapy is a dynamic state in which the observer can understand the movement and consequences that follow by simulating the movement action he is observing. It is a defined top-down approach based on basic neuroscience and the discovery of mirror neurons in physical therapy and rehabilitation. Movement exercises are performed by the patient in the form of watching the action first and then performing it.

The aim of action observation therapy is to heal neural circuits in the brain and rebuild movement function as an adjunct or alternative to classical physical therapy in people with brain damage. It uses mirror neuron activity for this.

How is Action Observation Therapy Done?

In the rehabilitation session, the patient first watches the video of the daily movement for a certain purpose. Then he tries to do the movement he followed. Each session is practiced for a single movement. Movement can be divided into three or four subcomponents. The realization of the movement can be watched from different angles in order to increase the performance.

Although there are no definite rules for the application of action observation therapy, we can say that it has two phases. During the observation phase, the patient is asked to watch the video carefully. In the implementation phase, he is expected to perform the movement he follows as accurately as possible.

A session takes half an hour on average. In the first few minutes, the physiotherapist explains the target to the patient. The video is watched carefully together, attention is drawn to the details of the movements. The patient is motivated. Then, the observation phase lasts for a total of 12 minutes, 3 minutes for each subcomponent in which the movement is divided. The patient then performs the 8-minute practice phase, 2 minutes for each movement component. Studies continue on the most appropriate session duration and number of repetitions.

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The studied movements can be divided into two groups. In transitive gestures, the person interacts with objects. An example of this is holding a pencil. In intransitive movements, there is no interaction with the item. For example, touching the tips of the thumb and forefinger is an intransitive gesture.

It is recommended that an appropriate outcome measure be used to evaluate the efficacy of therapy.

Mirror Neurons

Action observation therapy is a rehabilitation method designed based on the presence of mirror neurons. Mirror neurons were first observed in the macaque brain. They are neurons that are activated both during a certain movement and when it is watched by another individual. They have been found in humans in the premotor cortex, supplementary motor area, primary somatosensory cortex, and inferior parietal cortex. Although discussions on their functions continue, it is accepted that they take part in the learning of movements by imitation. They are claimed to help us understand the actions and intentions of other people. The neurophysiological basis of empathy may be mirror neurons. They may also have roles in language learning.

In Which Diseases Is It Used?

Action observation therapy has been shown to be an effective method for improving movement skills in people with stroke and Parkinson’s disease . It can also be used to support orthopedic rehabilitation processes such as rehabilitation after hip arthroplasty. As it is a relatively new method, not all areas where it could be useful have yet been explored.

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