Objectives

A novel method of rehabilitation for ideomotor apraxia (IMA), using a modified version of the mirror box (MB), is proposed. The rationale is based on the theory that disrupted body representation occurs in IMA and that MB training may improve body representation. In the present MB training, patients observed and reproduced movements made by the experimenter in a mirror. The visual perspective gave the illusory sensation of seeing one's own affected hand in the mirror.

Methods

Thirteen patients were included in the study; apraxia was measured four times: i) at baseline; ii) after a week of unspecific poststroke rehabilitation (rest); iii) after a week of imitation training for apraxia, used as a control; and iv) after a week of MB training. Imitation and mirror box training were presented in counterbalanced order between participants. The effect of the mirror box on a measure of body representation was also assessed.

Results

The results show that MB training improved apraxia when compared to the outcomes in both the imitation and rest conditions. The improvement correlates with the impact of the mirror box on the body representation (i.e., the degree of embodiment).

Conclusions

MB training shows promising effects in promoting recovery from apraxia. The hypothesis is that the mirror box triggers a quickly generated sense of embodiment of the reflected moving arm into the observer's body representation. This embodiment of the visuomotor features of the observed movements would positively affect motor programming, promoting motor improvement. Crucially, this effect seems to extend to actions performed outside the mirror box setup, enhancing patients' performance on an apraxia test.

中文翻译：

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重新控制有意行为：通过镜盒治疗改善意念运动失用症

目标

提出了一种使用镜盒 (MB) 的修改版本的意念运动失用症 (IMA) 康复新方法。其基本原理是基于 IMA 中发生身体表征中断的理论，并且 MB 训练可能会改善身体表征。在目前的 MB 训练中，患者观察并再现了实验者在镜子中的动作。视觉透视给人一种在镜子里看到自己受影响的手的幻觉。

方法

研究中包括了 13 名患者；失用症测量四次：i) 在基线；ii) 经过一周的非特异性中风后康复（休息）；iii) 经过一周的失用模仿训练，用作对照；iv) 经过一周的 MB 培训。模仿和镜盒训练在参与者之间以平衡的顺序呈现。还评估了镜盒对身体表征测量的影响。

结果

结果表明，与模仿和休息条件下的结果相比，MB 训练改善了失用症。改进与镜框对身体表现（即体现程度）的影响相关。

结论

MB 培训在促进失用症康复方面显示出有希望的效果。假设是镜盒触发了反射移动手臂的快速生成感，将其融入观察者的身体表征中。观察到的运动的视觉运动特征的这种体现将对运动编程产生积极影响，促进运动改善。至关重要的是，这种效果似乎扩展到镜箱设置之外执行的动作，提高了患者在失用症测试中的表现。