human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The clinical impact of action observation ( AO ) on upper limb functional recovery in subacute stroke patients is recent evidence . We sought to test the hypothesis that training everyday life activities through AO coupled with task execution might activate the left hemisphere different from the right one . Sixty-seven first-ever ischemic stroke subjects were r and omly assigned to receive upper limb training coupled with AO tasks or st and ard rehabilitation . The groups were matched by age and gender , Bamford category , and interval from stroke and lesion side . Fugl-Meyer ( FM ) and Box and Block Test ( BBT ) were used to measure h and function recovery at the end ( T1 ) and 4 - 5 months after the treatment ( T2 ) . At T1 , FM was increased by 31 % ( ±26 % ) , of maximum achievable recovery , whereas BBT was increased by 17 % ( ±18 % ) ; at T2 , FM had reached 43 % ( ±45 % ) of maximum recovery , while BBT had reached 25 % ( ±22 % ) . Combining the effects of treatment to those of lesion side revealed significantly higher gains , in both FM and BBT scores , in left hemiparetic subjects when exposed to AO as compared to st and ard rehabilitation alone ( P < .01 ) . The findings lead to recommend the use of AO in addition to motor training in left hemiparetic patients Background : The aim of this study was to explore the effects of action observation therapy on motor function of upper extremity , activities of daily living , and motion evoked potential in cerebral infa rct ion patients . Method : Cerebral infa rct ion survivors were r and omly assigned to an experimental group ( 28 patients ) or a control group ( 25 patients ) . The conventional rehabilitation treatments were applied in both groups , but the experimental group received an additional action observation therapy for 8 weeks ( 6 times per week , 20 minutes per time ) .  Fugl-Meyer assessment ( FMA ) , Wolf Motor Function Test ( WMFT ) , Modified Barthel Index ( MBI ) , and motor evoked potential ( MEP ) were used to evaluate the upper limb movement function and daily life activity . Results : There were no significant differences between experiment and control group in the indexes , including FMA , WMFT , and MBI scores , before the intervention . However , after 8 weeks treatments , these indexes were improved significantly . MEP latency and center-motion conduction time ( CMCT ) decreased from 23.82 ± 2.16 and 11.15 ± 1.68 to 22.69 ± 2.11 and 10.12 ± 1.46 ms . MEP amplitude increased from 0.61 ± 0.22 to 1.25 ± 0.38 mV. A remarkable relationship between the evaluations indexes of MEP and FMA was found . Conclusions : Combination of motion observation and traditional upper limb rehabilitation treatment technology can significantly elevate the movement function of cerebral infa rct ion patients in subacute seizure phase with upper limb dysfunction , which exp and ed the application range of motion observation therapy and provided an effective therapy strategy for upper extremities hemiplegia in stroke patients [ Purpose ] The purpose of this study was to suggest evidence d information about action observation to improve upper limb function after stroke . [ Methods ] A systematic review of r and omized controlled trials involving adults aged 18 years or over and including descriptions of action observation for improving upper limb function  was undertaken . Electronic data bases were search ed , including MEDLINE , CINAHL , and PEDro ( the Physiotherapy Evidence Data base ) , for articles published between 2000 to 2014 . Following completion of the search es , two review ers independently assessed the trials and extracted data using a data extraction form . The same two review ers independently documented the method ological quality of the trials by using the PEDro scale . [ Results ] Five r and omized controlled trials were ultimately included in this review , and four of them ( 80 % ) reported statistically significant effects for motor recovery of upper limb using action observation intervention in between groups . [ Conclusion ] This review of the literature presents evidence attesting to the benefits conferred on stroke patints result ing from participation in an action observation intervention . The body of literature in this field is growing steadily . Further work needs to be done to evaluate the evidence for different conditions after stroke and different duration of intervention Objective . A r and omized controlled observer-blind trial was design ed to evaluate the effectiveness of action observation as an add-on treatment to the st and ard rehabilitation of upper-limb function , early after stroke . Methods . Stroke survivors ( N = 102 ) were consecutively recruited from 13 centers 30 days ( ±7 ) after a first-ever stroke and r and omly assigned to the  experimental ( EG )  or  control group (  CG ) . EG participants watched video footage of daily routine tasks ( actions ) carried out with the upper limb in order to prepare to imitate the presented action . At the end of each sequence , a therapist prompted the patient to perform the same movement for 2 minutes , providing help when needed . Static images without animals or human beings were shown to the CG . At the end of each sequence , the CG executed movements that simulated the shoulder and elbow joint mobilization activities performed by the EG . Results for the Fugl-Meyer test , Frenchay Arm test , Box and Block test ( BBT ) , Modified Ashworth Scale , and Functional Independence Measure Motor items were recorded before treatment ( T0 ) , after 4 weeks of treatment ( T1 ) , and at the follow-up visit 4 to 5 months after the conclusion of treatment ( T2 ) . Results . An improvement over time was appreciated on all measures of impairment and functional ability with both treatment programs . A Time × Treatment interaction emerged from the generalized estimating equations analysis of BBT , showing significant T0–T1 and T0–T2 differences in favor of EG . Conclusion . This multicenter trial endorses the use of action observation in upper-extremity rehabilitation , along with a role for the mirror neuron system in poststroke recovery [ Purpose ] The purpose of this study was to identify the effect of purpose ful action observation on upper extremity function in patients with stroke . [ Subjects and Methods ] Twelve subjects were r and omly to either the experimental group or control group . The experimental group underwent occupational therapy and a purpose ful action observation program . The control group underwent occupational therapy and placebo treatment in which the subjects performed a purpose ful action observation program without actually observing the purpose ful actions . The Wolf Motor Function Test was used to measure upper extremity function before and after the intervention in both groups . [ Results ] Both the experimental and control groups demonstrated improved upper extremity function after the intervention , but there was no significant difference between groups . Compared with before the intervention , the experimental group showed significantly improved upper extremity function after the intervention . [ Conclusion ] Based on these results , a purpose ful action observation program can improve upper extremity function in patients with stroke . In future research , more subjects should be included for evaluation of different treatments The ability of motor training to encode a motor memory is reduced in older adults . Here , we tested the hypothesis that training-dependent memory encoding , an issue of relevance in neurorehabilitation , is enhanced in elder individuals by action observation which alone can contribute to learning processes . A group of 11 healthy older adults participated in this study , which consisted of three r and omized counterbalanced sessions on different days testing the effects of motor training ( MT ) alone , action observation ( AO ) alone , and a combination of both ( MT + AO ) on motor memory encoding . The combination of MT + AO formed a motor memory in the primary motor cortex and differentially modulated motor cortical excitability in muscles that were agonist and antagonist with respect to the training task , but MT or AO alone did not . These results suggest that action observation can enhance the effects of motor training on memory encoding protocol s in the older adult , possibly through Hebbian modulation of intracortical excitatory mechanisms OBJECTIVE The objective of this study was to compare the effects of action observation training and motor imagery training on recovery from  chronic stroke .  METHODS Thirty patients who were more than six months post stroke participated in this study and were r and omly allocated to three groups . The action observation training group practice d additional action observation training for five 30-minute sessions over a four-week period . The motor imagery training group practice d additional motor imagery training for five 30-minute sessions over a four-week period . The following clinical measures were used for assessment of dynamic balance and gait abilities : Timed Up and Go Test , Functional Reaching Test , Walking Ability Question naire , and Functional Ambulation Category . Spatiotemporal gait parameters were also collected using a GAITRite system . RESULT Compared with the physical training group , the action observation training group showed significant improvement in the Timed Up and Go test , gait speed , cadence , and single limb support of the affected side . No significant differences in any of the outcome measures were observed between the action observation training group and the motor imagery training group . CONCLUSION Action observation training and motor imagery training results in improvement of dynamic balance and gait ability . These results suggest the feasibility and suitability of action observation training for patients with chronic stroke Purpose : To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke . Design : R and omized , controlled pilot study . Setting : Inpatient rehabilitation hospital . Subjects : A total of 25 in patients with post-stroke hemiparesis were r and omly assigned to either the experimental group ( n = 12 ) or control group ( n = 13 ) . Intervention : Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes , three times a week for four weeks . Meanwhile , subjects of the control group watched video clips , which showed different l and scape pictures . Main measures : Walking function was evaluated before and after the four-week intervention using a 10-m walk test , community walk test , activities-specific balance confidence scale , and spatiotemporal gait measures . Results : Changes in the values for the 10-m walk test ( 0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s ) , community walk test ( –151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds ) , and activities-specific balance confidence ( 6.25 ±5.61 scores vs. 0.72 ±2.24 scores ) and the spatiotemporal parameters ( i.e. stride length ( 19.00 ±11.34 cm vs. 3.16 ±11.20 cm ) , single support ( 5.87 ±5.13 % vs. 0.25 ±5.95 % ) , and velocity ( 15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s ) ) indicated a significant improvement in the experimental group compared with the control group . In the experimental group , walking function and ambulation confidence was significantly different between the pre- and post-intervention , whereas the control group showed a significant difference only in the 10-m walk test . Conclusions : Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using intraclass correlation coefficients ( ICC [ 1,1 ] ) . RESULTS The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters . The ICC for the total score was.56 ( 95 % confidence interval=.47-.65 ) for ratings by individuals , and the ICC for consensus ratings was.68 ( 95 % confidence interval=.57-.76 ) . DISCUSSION AND CONCLUSION The reliability of ratings of PEDro scale items varied from " fair " to " substantial , " and the reliability of the total PEDro score was " fair " to " good . Objective : To investigate the effect of action observational training on walking ability  with chronic stroke patients . Design : A double-blind r and omized controlled trial . Setting : Inpatient rehabilitation hospital . Participants : Thirty chronic stroke patients . Interventions : Patients in both groups underwent treadmill training for 30 minutes . The action observational training group ( n = 15 ) watched a video of treadmill walking actions taken at various speeds before treadmill training for 10 minutes . The control group ( n = 15 ) watched a nature video unrelated to gait training for the same amount of time . All participants received training five times a week for a period of four weeks . Main measures : Timed up and go test , 10-metre walk test , 6-minute walk test and maximal flexed knee angle in the swing phase during walking . Results : There were significant improvements in timed up and go test ( –4.47 vs. –2.47 seconds ) , 10-m walk test ( 0.35 vs. 0.16 m/s ) , 6-minute walk test ( 93.13 vs. 32.53 m ) and maximal flexed knee angle in the swing phase during walking ( 7 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The clinical impact of action observation ( AO ) on upper limb functional recovery in subacute stroke patients is recent evidence . We sought to test the hypothesis that training everyday life activities through AO coupled with task execution might activate the left hemisphere different from the right one . Sixty-seven first-ever ischemic stroke subjects were r and omly assigned to receive upper limb training coupled with AO tasks or st and ard rehabilitation . The groups were matched by age and gender , Bamford category , and interval from stroke and lesion side . Fugl-Meyer ( FM ) and Box and Block Test ( BBT ) were used to measure h and function recovery at the end ( T1 ) and 4 - 5 months after the treatment ( T2 ) . At T1 , FM was increased by 31 % ( ±26 % ) , of maximum achievable recovery , whereas BBT was increased by 17 % ( ±18 % ) ; at T2 , FM had reached 43 % ( ±45 % ) of maximum recovery , while BBT had reached 25 % ( ±22 % ) . Combining the effects of treatment to those of lesion side revealed significantly higher gains , in both FM and BBT scores , in left hemiparetic subjects when exposed to AO as compared to st and ard rehabilitation alone ( P < .01 ) . The findings lead to recommend the use of AO in addition to motor training in left hemiparetic patients Background : The aim of this study was to explore the effects of action observation therapy on motor function of upper extremity , activities of daily living , and motion evoked potential in cerebral infa rct ion patients . Method : Cerebral infa rct ion survivors were r and omly assigned to an experimental group ( 28 patients ) or a control group ( 25 patients ) . The conventional rehabilitation treatments were applied in both groups , but the experimental group received an additional action observation therapy for 8 weeks ( 6 times per week , 20 minutes per time ) .  Fugl-Meyer assessment ( FMA ) , Wolf Motor Function Test ( WMFT ) , Modified Barthel Index ( MBI ) , and motor evoked potential ( MEP ) were used to evaluate the upper limb movement function and daily life activity . Results : There were no significant differences between experiment and control group in the indexes , including FMA , WMFT , and MBI scores , before the intervention . However , after 8 weeks treatments , these indexes were improved significantly . MEP latency and center-motion conduction time ( CMCT ) decreased from 23.82 ± 2.16 and 11.15 ± 1.68 to 22.69 ± 2.11 and 10.12 ± 1.46 ms . MEP amplitude increased from 0.61 ± 0.22 to 1.25 ± 0.38 mV. A remarkable relationship between the evaluations indexes of MEP and FMA was found . Conclusions : Combination of motion observation and traditional upper limb rehabilitation treatment technology can significantly elevate the movement function of cerebral infa rct ion patients in subacute seizure phase with upper limb dysfunction , which exp and ed the application range of motion observation therapy and provided an effective therapy strategy for upper extremities hemiplegia in stroke patients [ Purpose ] The purpose of this study was to suggest evidence d information about action observation to improve upper limb function after stroke . [ Methods ] A systematic review of r and omized controlled trials involving adults aged 18 years or over and including descriptions of action observation for improving upper limb function  was undertaken . Electronic data bases were search ed , including MEDLINE , CINAHL , and PEDro ( the Physiotherapy Evidence Data base ) , for articles published between 2000 to 2014 . Following completion of the search es , two review ers independently assessed the trials and extracted data using a data extraction form . The same two review ers independently documented the method ological quality of the trials by using the PEDro scale . [ Results ] Five r and omized controlled trials were ultimately included in this review , and four of them ( 80 % ) reported statistically significant effects for motor recovery of upper limb using action observation intervention in between groups . [ Conclusion ] This review of the literature presents evidence attesting to the benefits conferred on stroke patints result ing from participation in an action observation intervention . The body of literature in this field is growing steadily . Further work needs to be done to evaluate the evidence for different conditions after stroke and different duration of intervention Objective . A r and omized controlled observer-blind trial was design ed to evaluate the effectiveness of action observation as an add-on treatment to the st and ard rehabilitation of upper-limb function , early after stroke . Methods . Stroke survivors ( N = 102 ) were consecutively recruited from 13 centers 30 days ( ±7 ) after a first-ever stroke and r and omly assigned to the  experimental ( EG )  or  control group (  CG ) . EG participants watched video footage of daily routine tasks ( actions ) carried out with the upper limb in order to prepare to imitate the presented action . At the end of each sequence , a therapist prompted the patient to perform the same movement for 2 minutes , providing help when needed . Static images without animals or human beings were shown to the CG . At the end of each sequence , the CG executed movements that simulated the shoulder and elbow joint mobilization activities performed by the EG . Results for the Fugl-Meyer test , Frenchay Arm test , Box and Block test ( BBT ) , Modified Ashworth Scale , and Functional Independence Measure Motor items were recorded before treatment ( T0 ) , after 4 weeks of treatment ( T1 ) , and at the follow-up visit 4 to 5 months after the conclusion of treatment ( T2 ) . Results . An improvement over time was appreciated on all measures of impairment and functional ability with both treatment programs . A Time × Treatment interaction emerged from the generalized estimating equations analysis of BBT , showing significant T0–T1 and T0–T2 differences in favor of EG . Conclusion . This multicenter trial endorses the use of action observation in upper-extremity rehabilitation , along with a role for the mirror neuron system in poststroke recovery [ Purpose ] The purpose of this study was to identify the effect of purpose ful action observation on upper extremity function in patients with stroke . [ Subjects and Methods ] Twelve subjects were r and omly to either the experimental group or control group . The experimental group underwent occupational therapy and a purpose ful action observation program . The control group underwent occupational therapy and placebo treatment in which the subjects performed a purpose ful action observation program without actually observing the purpose ful actions . The Wolf Motor Function Test was used to measure upper extremity function before and after the intervention in both groups . [ Results ] Both the experimental and control groups demonstrated improved upper extremity function after the intervention , but there was no significant difference between groups . Compared with before the intervention , the experimental group showed significantly improved upper extremity function after the intervention . [ Conclusion ] Based on these results , a purpose ful action observation program can improve upper extremity function in patients with stroke . In future research , more subjects should be included for evaluation of different treatments The ability of motor training to encode a motor memory is reduced in older adults . Here , we tested the hypothesis that training-dependent memory encoding , an issue of relevance in neurorehabilitation , is enhanced in elder individuals by action observation which alone can contribute to learning processes . A group of 11 healthy older adults participated in this study , which consisted of three r and omized counterbalanced sessions on different days testing the effects of motor training ( MT ) alone , action observation ( AO ) alone , and a combination of both ( MT + AO ) on motor memory encoding . The combination of MT + AO formed a motor memory in the primary motor cortex and differentially modulated motor cortical excitability in muscles that were agonist and antagonist with respect to the training task , but MT or AO alone did not . These results suggest that action observation can enhance the effects of motor training on memory encoding protocol s in the older adult , possibly through Hebbian modulation of intracortical excitatory mechanisms OBJECTIVE The objective of this study was to compare the effects of action observation training and motor imagery training on recovery from  chronic stroke .  METHODS Thirty patients who were more than six months post stroke participated in this study and were r and omly allocated to three groups . The action observation training group practice d additional action observation training for five 30-minute sessions over a four-week period . The motor imagery training group practice d additional motor imagery training for five 30-minute sessions over a four-week period . The following clinical measures were used for assessment of dynamic balance and gait abilities : Timed Up and Go Test , Functional Reaching Test , Walking Ability Question naire , and Functional Ambulation Category . Spatiotemporal gait parameters were also collected using a GAITRite system . RESULT Compared with the physical training group , the action observation training group showed significant improvement in the Timed Up and Go test , gait speed , cadence , and single limb support of the affected side . No significant differences in any of the outcome measures were observed between the action observation training group and the motor imagery training group . CONCLUSION Action observation training and motor imagery training results in improvement of dynamic balance and gait ability . These results suggest the feasibility and suitability of action observation training for patients with chronic stroke Purpose : To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke . Design : R and omized , controlled pilot study . Setting : Inpatient rehabilitation hospital . Subjects : A total of 25 in patients with post-stroke hemiparesis were r and omly assigned to either the experimental group ( n = 12 ) or control group ( n = 13 ) . Intervention : Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes , three times a week for four weeks . Meanwhile , subjects of the control group watched video clips , which showed different l and scape pictures . Main measures : Walking function was evaluated before and after the four-week intervention using a 10-m walk test , community walk test , activities-specific balance confidence scale , and spatiotemporal gait measures . Results : Changes in the values for the 10-m walk test ( 0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s ) , community walk test ( –151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds ) , and activities-specific balance confidence ( 6.25 ±5.61 scores vs. 0.72 ±2.24 scores ) and the spatiotemporal parameters ( i.e. stride length ( 19.00 ±11.34 cm vs. 3.16 ±11.20 cm ) , single support ( 5.87 ±5.13 % vs. 0.25 ±5.95 % ) , and velocity ( 15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s ) ) indicated a significant improvement in the experimental group compared with the control group . In the experimental group , walking function and ambulation confidence was significantly different between the pre- and post-intervention , whereas the control group showed a significant difference only in the 10-m walk test . Conclusions : Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using intraclass correlation coefficients ( ICC [ 1,1 ] ) . RESULTS The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters . The ICC for the total score was.56 ( 95 % confidence interval=.47-.65 ) for ratings by individuals , and the ICC for consensus ratings was.68 ( 95 % confidence interval=.57-.76 ) . DISCUSSION AND CONCLUSION The reliability of ratings of PEDro scale items varied from " fair " to " substantial , " and the reliability of the total PEDro score was " fair " to " good . Objective : To investigate the effect of action observational training on walking ability  with chronic stroke patients . Design : A double-blind r and omized controlled trial . Setting : Inpatient rehabilitation hospital . Participants : Thirty chronic stroke patients . Interventions : Patients in both groups underwent treadmill training for 30 minutes . The action observational training group ( n = 15 ) watched a video of treadmill walking actions taken at various speeds before treadmill training for 10 minutes . The control group ( n = 15 ) watched a nature video unrelated to gait training for the same amount of time . All participants received training five times a week for a period of four weeks . Main measures : Timed up and go test , 10-metre walk test , 6-minute walk test and maximal flexed knee angle in the swing phase during walking . Results : There were significant improvements in timed up and go test ( –4.47 vs. –2.47 seconds ) , 10-m walk test ( 0.35 vs. 0.16 m/s ) , 6-minute walk test ( 93.13 vs. 32.53 m ) and maximal flexed knee angle in the swing phase during walking ( 7 
    Output:
    