https://scholars.lib.ntu.edu.tw/handle/123456789/634672
Title: | Attentional focus effect on dual-task walking in Parkinson's disease with and without freezing of gait | Authors: | Chen, Yu-An RUEY-MEEI WU Sheu, Chen-Hsing CHIN-HSIEN LIN CHENG-YA HUANG |
Keywords: | Attention; Dual task; Freezing of gait; Locomotion | Issue Date: | Feb-2023 | Journal Volume: | 45 | Journal Issue: | 1 | Start page/Pages: | 177 | Source: | GeroScience | Abstract: | In Parkinson's disease, the optimal attentional focus strategy for dual-task walking may vary with freezing of gait (FOG), due to different severities of impaired automaticity. The study aimed to investigate (i) the immediate effect of attentional focus on dual-task walking in participants with and without FOG, and (ii) the training effect of attentional focus on walking, FOG, and falls. In experiment 1, FOG and non-FOG groups (16 participants each) performed a dual-task of holding two interlocking rings apart while walking, either without attention instruction or with instructions to focus attention internally or externally. Gait parameters and ring-touching times were measured. In experiment 2, 30 participants with FOG were randomized to 6 weeks of dual-task training with internal-focus or external-focus instruction. Before and after training, we recorded timed up-and-go (TUG) and TUG dual-task (TUGdt) in on-medication and off-medication states, and the numbers of FOG episodes and falls. The non-FOG group showed less step length variability and shorter ring-touching times with external-focus. The FOG group showed less step length variability, less cadence, increased gait velocity, and longer step lengths with internal-focus compared to external-focus and no-focus instructions. Both internal-focus and external-focus training reduced FOG and falls after intervention, but only internal-focus training reduced TUG and TUGdt in both on-medication and off-medication states. Our findings suggest external-focus would enhance walking automaticity and the concurrent task accuracy for non-freezers, whereas for freezers, internal-focus could increase gait stability and lead to a more positive effect on improving locomotion control and reducing falling risk. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/634672 | ISSN: | 25092715 | DOI: | 10.1007/s11357-022-00606-3 |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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