The effect of imitation movement on motor impairment after brain damage:Clinical application of mirror neuron system
Imitation learning is one of the most effective ways for acquiring a new motor skill.It is known that imitation learning occurs even in the early stage of development and plays an important role in our development,because we learn native language and other important skills by imitation learning.Recently,many studies have reported that the underlying neural mechanism of imitation is the mirror neuron system(MNS)in motor related areas that is activated both during generating action and during observing action done by others.The activation during observation of another persons action in the MNS can reflect a neural process to simulate a same or similar action done by others,in other words,to generate a motor program of the observing action utilizing visual information.By repeating imitation,our brain can solely build a motor program without visual information of action done by others and thus we acquire a new motor skill.Motor paresis of limb after brain damage is a motor impairment,which is caused by damage to motor related area,in voluntary movement of the limb neurally innervated and controlled by the damaged brain area.Many patients with motor paresis claim that they do not know and forget how to move their paretic limb in trying to move it because a motor program for paretic limb cannot be generated.Imitation learning could be effective for the patients without ability to generate a motor program for paretic limb,because imitation movement help to generate a motor program by utilizing visual information of another persons action.Here,we examined the effect of imitation movement as rehabilitation to the two patients with motor paresis after brain damage.Two patients with motor impairment after brain damage in chronic stage were participated in our study and we gave imitation training of upper limb to case 1 and training of lower limb to case 2.In imitation training,the patients watched the motion of upper or lower limb movement in the first persons perspective performed by experimenter by a head-mounted display.In case 1,the patient is 47 years old female with right hemiparesis,and especially unable to move right ankle voluntarily,which was caused by damage to supplementary motor area,left dorsal premotor,and primary motor area.We used extension-flexion cyclic movements in right ankle as imitation training.In case 2,the patient was a 20 years old male with right hemi paresis caused by left putaminal damage by a traffic accident.His right hand and fingers were completely loss in grip force and we used open-close cyclic movements in right finger as imitation training for 30 min.twice in a week.Movement,muscle activity and grip force of the patients during movement were recorded with a goniometer,EMG recorder and electro hand dynamometer respectively.In case 1,the patient could move her ankle only during imitation without feeling her ankle moving,while not moving her ankle at all with no muscle activity during watching her ankle directly.Immediately after imitation,the patient could move her ankle smoothly in direct view of her ankle.In case 2,imitation training improved the grasping power approximately up to 7 kg from 0 kg for about 2 months.Imitation movement and training could improve motor impairment of the patients after brain damage not only in joint movement(case 1)but also in production of power(case 2).These results show that imitation movement and training is very useful and effective for rehabilitation of motor impairment after brain damage,especially for the patients with severe motor impairment who cannot move their paretic limb at all.
Mirror Neuron System Imitation Learning Neurorehabilitation brain damaged
Yutaka Oouchida Shin-ichi Izumi
Department of Physical Medicine and Rehabilitation Tohoku university Sendai,Japan 980-8575 Graduate School of Medical Engineering Tohoku university Sendai,Japan 980-8575
国际会议
The 2014 ICME International Conference on Complex Medical Engineering (CME2014)ICME复合医学工程国际会议
台北
英文
138-143,90-91
2014-06-26（万方平台首次上网日期，不代表论文的发表时间）