For Stroke Victims, Action-Observation Shows Promise

One of the challenges for people recovering from strokes is re-learning motor skills that are controlled by the damaged sectors of the brain. New research has found a promising treatment in action-observation, a process that involves watching others perform activities that the stroke victim is struggling to relearn.

Researchers at the University of Southern California put 24 participants through a functional magnetic resonance imaging (fMRI) scan—12 who had suffered strokes and 12 who had not, but who were age-matched to the stroke victims. While undergoing the fMRI, both groups of participants watched others perform actions that would be difficult for the stroke victims, like lifting a pencil or flipping a card. The people performing the actions used the same arm or hand that was affected in the stroke victims.

The study found that non-stroke affected brains responded to this input by lighting up the cortical motor regions, which is typical brain activity for watching others perform actions. However, in the stroke victims’ brains, the strongest activity was found in parts of the damaged hemisphere in the areas that control actions they would find difficult.

Carolee Winstein, director of the Motor Behavior and Neurorehabilitation Laboratory in the Division of Biokinesiology and Physical Therapy at USC explained that for stroke victims, watching others perform actions is like “priming the pump … You’re getting these circuits engaged through the action-observation before they even attempt to move.” Watching others can help drive plasticity in the affected regions of the brain—exercising the circuits—which could help victims to recover the use of a hand or arm that they thought they had lost for good.

There has been some previous research on the action-observation method, but this is the first to explain the rationale behind the treatment. Identifying patients who show a strong response to action-observation during an fMRI may be the best candidates for rehabilitation that involves action-observation.

The research was published in the June edition of the journal Stroke.