Quantitative EEG for the Monitoring of Walking Recovery in Chronic Stroke Patients Receiving Action Observation Training

Abstract

The current study aimed to evaluate the effects of action observation on the walking ability and oscillatory brain activity of chronic stroke patients. Fourteen chronic stroke patients were allocated randomly to the action observation (AO) or sham observation (SO) groups. Both groups received 12 sessions of intervention. Each session composed of 12 min of observational training, which depicted exercises for the experimental group but nature pictures for the sham group and 40 min of occupational therapy, which was the same for the both groups. Walking ability was assessed by a motion analysis system and brain activity was monitored using quantitative electroencephalography (QEEG) before and after the intervention. Brain asymmetry at alpha frequency, the percentage of stance phase, and step length showed significant changes in the AO group. Only the change in global alpha power was significantly correlated with the change in velocity after the intervention in AO group. Despite more improvements in walking and brain activity of patients in the AO group, our study failed to show significant correlations between the brain activity changes and functional improvements after the intervention, which might be mainly due to the small sample size in our study. Trial registration: IRCT20181014041333N1

Keywords:

• QEEG
• chronic stroke
• mirror neuron
• gait
• motor performance

ACKNOWLEDGMENTS

Authors appreciate support from DANA Brain Health Institute (DBHI), Shiraz, Iran, and Simorgh Occupational Therapy Center, Shiraz, Iran. The authors also thank Mr. Zahediannasb and Ms. Hekamtnia for their assistance during the implementation of this study and all patients for participating in this study.

AUTHORS’ CONTRIBUTIONS

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Fatemeh Shamsi, Mohammad Nami, and Mohammad Taghi Karimi. The first draft of the manuscript was written by Fatemeh Shamsi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

ETHICAL STANDARDS

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

ETHICAL APPROVAL

Approval for this clinical randomized trial was obtained from the ethics committee of Shiraz University of Medical Sciences (Ethics Committee code: IR.SUMS.REC.1397.564), and it was conducted under the Declaration of Helsinki.

CONSENT TO PARTICIPATE

Informed consent was obtained from all participants included in the study.

DISCLOSURE STATEMENT

The authors have no relevant financial or non-financial interests to disclose.

DATA AVAILABILITY STATEMENT

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon a reasonable request.

Additional information

Funding

The present study was financially supported by Shiraz University of Medical Sciences (Grant no. 1397-01-74-16502). This article was extracted from part of the PhD thesis titled “The effect of action observation training on kinetic and kinematic parameters of gait and QEEG patterns of chronic stroke patients with hemiparetic gait” by F. Shamsi under the supervision of Dr. M. Nami.