Abstract
BackgroundThis study evaluated the effect of attentional focus instructions on movement efficiency during a level-ground walking task in older adults with and without a history of falls.MethodsOne hundred and thirty-four community-dwelling older adults were categorised into older fallers (OF) (n = 37) and older non-fallers (ONF) (n = 97). Each participant was instructed to walk at a self-selected pace along a 6 m walkway under three attentional focus conditions (i.e. internal, goal-directed and control) for a total of nine trials. Average muscle activity indices of lower limb co-contractions were measured using surface electromyography.ResultsBoth shank and thigh muscle co-contractions were higher in OF than in ONF in all three conditions. OF also demonstrated higher shank muscle co-contraction under the internal relative to the goal-directed condition, with no such change observed in ONF.ConclusionDespite no significant between-group differences in functional balance and balance confidence, relative walking inefficiencies were observed in OF compared with ONF. This finding demonstrates the debilitating consequences of falling that can occur with relative independence from various physiological or psychological factors that are commonly associated with falling and used to rationalise behavioural change. We also provide evidence that OF are more susceptible to conditions that provoke them to allocate attention internally. Therefore, in clinical contexts (e.g. gait rehabilitation), verbal instructions that refer to body movements (internal focus) might serve to compromise movement efficiency in older adults with a history of falls. Such changes will, theoretically, lessen the ability to react efficiently to changing environments experienced in daily life.
Highlights
The ability to walk safely and efficiently is essential for older adults to maintain independence and minimise fall risk [1]
Research in motor control has examined the influence of altered attentional focus on motor performance, where guiding/instructing performers to adopt an external/goal-directed attentional focus is generally associated with improved performance and efficiency [4]
Our data show that lower limb muscle co-contractions were higher in older fallers (OF) compared with older non-fallers (ONF) after largely eliminating the effect of functional mobility, balance ability and balance confidence
Summary
• The effect of attentional focus instructions on walking efficiency was evaluated between fallers and non-fallers. • Lower limb muscle co-contractions differ between fallers and non-fallers. • Differences in muscle co-contractions appear to be unrelated to balance ability and balance confidence. • Internal focus instructions compromise walking efficiency in fallers by virtue of a ‘stiffening strategy’. • A cautious ‘stiffening strategy’ may be associated with reduced gait stability in older fallers
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.