Corticospinal excitability is facilitated during coordinative action observation and motor imagery.

Combined action observation and motor imagery (AOMI) facilitates corticospinal excitability (CSE). This study used single-pulse transcranial magnetic stimulation (TMS) to explore changes in CSE for coordinative AOMI, where the observed and imagined actions are related but not identical, for a single-leg sit-to-stand (SL-STS) movement. Twenty-one healthy adults completed two testing sessions including baseline (BL), action observation (AO), and motor imagery (MI) control conditions, and three experimental conditions where they observed a slow-paced SL-STS while simultaneously imagining a slow- (AOMIHICO), medium- (AOMIMOCO), or fast-paced (AOMILOCO) SL-STS. A TMS pulse was delivered to the right leg representation of the left primary motor cortex at three stimulation timepoints aligned with peak electromyography (EMG) activity of the knee extensor muscle group for the fast- (T1), medium- (T2), and slow-paced (T3) SL-STS during each condition. Motor evoked potential (MEP) amplitudes were recorded from the knee extensor muscle group as a marker of CSE for all stimulation timepoints and conditions. A main effect for experimental condition was reported for all stimulation timepoints. MEP amplitudes were significantly greater for AOMIHICO at T1 and T3, and AOMIMOCO and AOMILOCO at all stimulation timepoints, when compared with control conditions. This study provides neurophysiological evidence supporting the use of coordinative AOMI.