title: Action observation improves freezing of gait in patients with Parkinson's disease.
abstract: BACKGROUND
  Freezing of gait (FOG) is a disabling impairment for people with Parkinson's disease (PD) and may not respond to medications. The effectiveness of physical therapy for FOG is debatable. Action observation strategies to overcome FOG may enhance physical training.
  
  
  OBJECTIVE
  To assess whether action observation, combined with practicing the observed actions, may reduce FOG episodes.
  
  
  METHODS
  Twenty patients with PD entered a single-blind trial and were randomly assigned to the experimental (Action) or control (Landscape) groups. Those in the Action group watched video clips showing specific movements and strategies to circumvent FOG episodes, whereas those in the Landscape group watched video clips of static pictures showing different landscapes. All patients underwent identical physical therapy training, 3 sessions a week for 4 weeks.
  
  
  RESULTS
  The FOG Questionnaire score and the number of FOG episodes were significantly reduced in both groups after the training period. At follow-up examination (4 weeks after the end of the intervention), a significant reduction in the number of FOG episodes was observed only in the Action group. Motor performance (walking and balance) and quality-of-life assessments were significantly improved in both groups at the end of training and at follow-up.
  
  
  CONCLUSIONS
  Our results suggest that action observation has a positive additional effect on recovery of walking ability in PD patients with FOG. Further studies on the combination of observation and imitation to supplement a physical training program may result in an innovative rehabilitative approach for FOG.
authors.affiliation: University of Genoa, Genova, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pelosin
authors.forename: Laura
authors.initials: L
authors.lastname: Avanzino
authors.forename: Marco
authors.initials: M
authors.lastname: Bove
authors.forename: Paola
authors.initials: P
authors.lastname: Stramesi
authors.forename: Alice
authors.initials: A
authors.lastname: Nieuwboer
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbruzzese
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009039:Motion Perception; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D010775:Photic Stimulation / Q000379:methods; D026741:Physical Therapy Modalities / Q000523:psychology*; D004856:Postural Balance; D011597:Psychomotor Performance; D020127:Recovery of Function; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016138:Walking / Q000523:psychology*