Focus of Attention Effect on Sit to Stand Symmetry in Individuals Post Chronic Stroke: A Randomized Cross-over Trial
Western Carolina University
Summary
The purpose of this study is to fill some gaps in the literature by examining the effects of focus of attention on motor learning and motor performance of sit to stand in individuals post chronic stroke. This study will investigate whether an internal or external focus of attention can lead to improved use of the affected lower extremity during the sit to stand transition, while maintaining an upright trunk position. More specifically, the study has two purposes. The first is to determine whether an external or internal focus of attention would lead to better motor learning of sit to stand. This is measured by retention testing and transfer of the task to changes in affected lower extremity weight bearing during gait. The second purpose of this study is to investigate whether an internal or external focus of attention affects the performance of sit to stands during training.
Description
Participant demographics and clinical information will be collected, including age, gender, weight, height, location of stroke, how long ago the stroke occurred, and fall history. All participants will consent to participation in this study. The Star Cancellation Test, NIH Stroke Scale (NIHSS), and Montreal Cognitive Assessment (MOCA) will be used to determine eligibility. Fugl Meyer Motor Scale for the lower extremity, excluding reflexes, will also be completed to help describe the sample. Blood pressure, heart rate, and oxygen saturation, via a pulse oximeter, will be taken and a gait belt w…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Stroke \>6 months * Mild to moderate stroke (NIHSS scores 0-15) Exclusion Criteria: * Unable to perform sit to stand from a standard height 20" chair without physical assistance * Unable to walk 20 feet with or without an assistive device at a contact guard to independent level * Individuals with severe cognitive impairment (\<10/30 on the Montreal Cognitive assessment) * Contraversive pushing (\> 1 on the Scale for Contraversive Pushing) * Neglect as evidenced by \<44/54 on the star cancellation test * Any orthopedic conditions that impact their ability to transition…
Interventions
- OtherFocus of Attention
Focus of attention instruction and feedback. Focus of attention refers to what people are thinking about during motor tasks. An external focus refers to thinking about an outside outcome or target. An internal focus of attention refers to thinking about how someone is moving their body. During training, participants performed four sets of sit to stand transitions with the mat at progressively lower seat heights to increasingly challenge the participants, with instruction and feedback consistent with their condition allocation. The four sets occurred in the following sequences: 130% of the initial mat height determined at baseline assessment 120%, 110%, and 100%. Each set ended after the tenth repetition or when the participant reported an RPE rating of \>16/20. During training, one verbal correction was given during each set after the second, fourth, and seventh repetition.
Location
- Western Carolina UniversityCullowhee, North Carolina