Action observation motor rehabilitation in children with cerebral palsy

Action observation therapy (AOT) has been developed on the basis of mirror neuron system (MNS) theory and suggests that the observation of action could be used to improve both the planning and execution of patient’s motor actions through common observation and execution neural processes. For this study, we adapted AOT to children with cerebral palsy (CP) in order to rehabilitate their upper limb movement function. Seven children with hemiplegic congenital CP were tested. Assessment consisted of body structure and function (force, fine and gross manual dexterity, and quality of movement measured with a robotic device), activity limitation and participation restriction measures. The experimental condition consisted of the participants viewing videos showing a first person perspective of a child’s daily living activities with a narrative A single blind cross over design was used. The results showed significant action improvements for four of the seven children on the measures of body structure and function, and activity limitation. The initial level of action ability appeared to explain the efficacy of the therapy. This study is one the first to use AOT in children with CP, and to assess the three dimensions of handicap including accurate kinematics measures. It seems that the level of manual ability may predict the functions of the MNS; children with poor manual ability may have reduced MNS capacity, influencing the efficacy of the rehabilitation effect. These findings support the use of AOT as a promising rehabilitative tool for children with CP