A commentary on Eaves et al. with a special focus on clinical neurorehabilitation

TL;DR

This commentary discusses how to apply action observation and motor imagery in neurorehabilitation, especially for stroke patients.

Contribution

It suggests practical considerations for implementing AO+MI in clinical settings, focusing on patient readiness and training methods.

Findings

Synchronous AO+MI may be unsuitable due to cognitive load in some patients.

Asynchronous AO and MI could be more effective for neurorehabilitation.

Patient screening and familiarization are essential before AO+MI training.

Abstract

We very much appreciate the theoretical foundations and considerations of AO, MI, and their combination AO + MI by Eaves et al. In their exploratory review, the authors highlight the beneficial effects of the combined use of AO and MI, with a particular focus on synchronous AO and MI. From a neurorehabilitation perspective, different processes may apply to patients, particularly after a stroke. As suggested by Eaves et al., the cognitive load might prevent the use of synchronous AO + MI and the asynchronous application of AO and MI might be indicated. Furthermore, some aspects should be considered when applying AO + MI in rehabilitation: screening for the patients’ cognitive capabilities and MI ability, and a familiarisation programme for AO and MI, before starting with an AO + MI training. With their review, Eaves et al. propose a number of research questions in the field of neurorehabilitation that urgently need to be addressed: the use of asynchronous vs. synchronous AOMI, observation and imagination with or without errors, or use of different MI perspectives and modes in different learning stages. This commentary provides some additional suggestions on patients’ MI ability and cognitive level, MI familiarisation and detailed reporting recommendations to transfer Eaves et al. findings into clinical practice.