Original articleAction Observation Treatment Improves Recovery of Postsurgical Orthopedic Patients: Evidence for a Top-Down Effect?
Section snippets
Participants
All patients consecutively admitted to our Department of Rehabilitation and Aged Care for postorthopedic (hip fracture or hip or knee replacement) surgery rehabilitation from November 2008 to November 2009 were eligible for this study if the surgical intervention was the first during their lifetime and time from surgery to department admission ranged from 3 to 10 days. On admission at t0, a standardized multidimensional assessment was performed to evaluate the patient's eligibility criteria,
Results
Of 72 potentially eligible patients, 60 fulfilled the inclusion criteria, agreed to participate, and were enrolled in this study. Patients were randomly assigned to the case (n=30) and control groups (n=30). None of the patients was absent from scheduled sessions during the study, and all completed the treatment.
Clinical features of the 2 groups are listed in table 2. Baseline comparisons showed that age, sex, type of orthopedic surgical intervention, time from surgery to randomization,
Discussion
The present findings clearly show that AOT is a useful approach in the rehabilitation of postsurgical orthopedic patients and may be complementary or alternative to current well-assessed rehabilitation treatments. To date, AOT has been used in only the recovery of upper-limb function in long-term patients after stroke. A functional magnetic resonance imaging study,18 including a small group (N=8) of patients who underwent AOT, showed functional reorganization of the motor system, especially in
Conclusions
The present study further supports the potential application of AOT, clearly showing a positive effect of this approach even in rehabilitation of patients with nonneurologic diseases, such as recovery from orthopedic surgery. In more general terms, the present findings suggest a top-down effect, showing that reorganization of motor representations at a central level (occurring during AOT) may positively influence action execution, even when the skeletal structures to implement the movement are
Acknowledgments
We thank Marina Marazzi, MD, Fabio Guerini, MD, Salvatore Speciale, MD, Valeria Tirelli, MD, Renato Turco, MD, Tiziana Torpilliesi, MD, Eleonora Ricci, MD, and Tommaso Luccarini, physiotherapist, for support in collecting data.
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