Abstract
Falls represent a substantial risk in the elderly. Previous studies have found that a focus on the outcome or effect of the movement (external focus of attention) leads to improved balance performance, whereas a focus on the movement execution itself (internal focus of attention) impairs balance performance in elderly. A shift toward more conscious, explicit forms of motor control occurs when existing declarative knowledge is recruited in motor control, a phenomenon called reinvestment. We investigated the effects of attentional focus and reinvestment on gait stability in elderly fallers and nonfallers. Full body kinematics was collected from twenty‐eight healthy older adults walking on a treadmill, while focus of attention was manipulated through instruction. Participants also filled out the Movement Specific Reinvestment Scale (MSRS) and the Falls Efficacy Scale International (FES‐I), and provided details about their fall history. Coefficients of Variation (CV) of spatiotemporal gait parameters and Local Divergence Exponents (LDE) were calculated as measures of gait variability and gait stability, respectively. Larger stance time CV and LDE (decreased gait stability) were found for fallers compared to nonfallers. No significant effect of attentional focus was found for the gait parameters, and no significant relation between MSRS score (reinvestment) and fall history was found. We conclude that external attention to the walking surface does not lead to improved gait stability in elderly. Potential benefits of an external focus of attention might not apply to gait, because walking movements are not geared toward achieving a distinct environmental effect.
Highlights
In the elderly population, falls represent a substantial risk
The larger Falls Efficacy Scale International (FES-I) score, smaller step width Coefficients of Variation (CV) and smaller step length for fallers compared to nonfallers was borderline significant (Fig. 2 & Table 1)
The higher Local Divergence Exponents (LDE) and stance time CV indicated significantly lower gait stability and increased gait variability for fallers compared to nonfallers
Summary
It has been suggested that fall risk is larger for individuals with a higher level of conscious attention to their own movements than the general population (Wong et al 2008; Chiviacowsky et al 2010; Wulf 2013; Young et al 2016). It has further been suggested that the fall risk of such individuals might be reduced if their movements would be more automated and require less attentional control a 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.
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