An external focus of attention compared to an internal focus of attention improves anticipatory postural adjustments among people post-stroke

Aloraini, Saleh M.; Glazebrook, Cheryl M.; Pooyania, Sepideh; Sibley, Kathryn M.; Singer, Jonathan C.; Passmore, Steven

doi:10.1016/j.gaitpost.2020.08.133

Cited by 8 publications

(11 citation statements)

References 27 publications

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“…With such a ballistic movement aiming the dart to the bull's-eye, which involves the slight elbow flexion and almost full extension, is a more intended and goal-directed action. Thus, our findings suggested that a multijoint movement and an intended and goal-directed ballistic movement can induce the longer time of the APA and, therefore, improve the posture control in an efficient way (Aloraini et al, 2019(Aloraini et al, , 2020. In the rehabilitation for the elderly people or the patients with CNS disorders, the great APA might be induced by performing the multi joints movement and more intended and goaldirected action, but not just performing the ballistic upper limb movement.…”

Section: Clinical Applicationsmentioning

confidence: 83%

Corticospinal Excitability of the Lower Limb Muscles During the Anticipatory Postural Adjustments: A TMS Study During Dart Throwing

Matsumoto

Liang

Ueda

et al. 2021

Front. Hum. Neurosci.

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Objective: To investigate whether the changes in the corticospinal excitability contribute to the anticipatory postural adjustments (APAs) in the lower limb muscles when performing the ballistic upper limb movement of the dart throwing.Methods: We examined the primary motor cortex (M1) excitability of the lower limb muscles [tibialis anterior (TA) and soleus (SOL) muscles] during the APA phase by using transcranial magnetic stimulation (TMS) in the healthy volunteers. The surface electromyography (EMG) of anterior deltoid, triceps brachii, biceps brachii, TA, and SOL muscles was recorded and the motor evoked potential (MEP) to TMS was recorded in the TA muscle along with the SOL muscle. TMS at the hotspot of the TA muscle was applied at the timings immediately prior to the TA onset. The kinematic parameters including the three-dimensional motion analysis and center of pressure (COP) during the dart throwing were also assessed.Results: The changes in COP and EMG of the TA muscle occurred preceding the dart throwing, which involved a slight elbow flexion followed by an extension. The correlation analysis revealed that the onset of the TA muscle was related to the COP change and the elbow joint flexion. The MEP amplitude in the TA muscle, but not that in the SOL muscle, significantly increased immediately prior to the EMG burst (100, 50, and 0 ms prior to the TA onset).Conclusion: Our findings demonstrate that the corticospinal excitability of the TA muscle increases prior to the ballistic upper limb movement of the dart throwing, suggesting that the corticospinal pathway contributes to the APA in the lower limb in a muscle-specific manner.

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Section: Clinical Applicationsmentioning

confidence: 83%

Corticospinal Excitability of the Lower Limb Muscles During the Anticipatory Postural Adjustments: A TMS Study During Dart Throwing

Matsumoto

Liang

Ueda

et al. 2021

Front. Hum. Neurosci.

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“…At a performance level, previous work utilising a Fitts’ task in the lower limb (i.e. a fast one-leg movement) showed that EF led to better motor performance, longer APA duration, and smaller APA magnitude than IF 38 , 39 , suggesting that the standing posture might be controlled more efficiently when adopting an EF strategy. The difference in motor task or interlimb/intralimb coordination might explain the difference between the previous and present results.…”

Section: Discussionmentioning

confidence: 94%

External and internal focus of attention differentially modulate corticospinal excitability in anticipatory postural adjustments

Matsumoto

Ueda

Ogawa

et al. 2022

Sci Rep

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Whether attentional focus modulates the corticospinal excitability of the lower limb muscles in anticipatory postural adjustments (APAs) when performing a ballistic movement of the upper limb remains unclear. The present study used transcranial magnetic stimulation (TMS) to examine the corticospinal excitability of the lower limb muscles along with the kinematic profiles during dart throwing with different attentional foci, external focus (EF) and internal focus (IF). In 13 healthy participants, TMS was applied immediately before electromyographic onset of the tibialis anterior (TA) muscle, and the motor evoked potential (MEP) was recorded in the TA and soleus (SOL) muscles. The performance accuracy was significantly higher in the EF condition than in the IF condition. In both EF and IF conditions, MEP amplitude in the TA muscle, but not the SOL muscle, was significantly higher immediately before TA muscle onset (− 100, − 50, and 0 ms) compared to the control. In particular, the MEP increment in the TA muscle before TA muscle onset (− 50 and 0 ms) was significantly larger in the EF condition than in the IF condition. Our findings provide the first evidence for the modulation of corticospinal excitability in APA by changing attentional focus.

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“…It is possible that due to the instructed attentional focus participants may have adopted new or adapted current motor strategies, such as changes in anticipatory postural adjustments or muscle activations [ 11 , 40 , 41 ]. A previous study by Richer et al (2017) investigating attentional focus during a standing balance task revealed no statistically significant differences in ankle muscle activation when participants adapt to internal versus external focus [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of external and internal focus of attention on visual dependence and EEG alpha oscillations during postural control

Lei

Marshall

Wright

2022

J NeuroEngineering Rehabil

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Background The ability to maintain upright posture requires successful integration of multiple sensory inputs (visual, vestibular, and somatosensory). When one or more sensory systems become unreliable, the postural control system must “down-weight” (or reduce the influence of) those senses and rely on other senses to maintain postural stability. As individuals age, their ability to successfully reweight sensory inputs diminishes, leading to increased fall risk. The present study investigates whether manipulating attentional focus can improve the ability to prioritize different sensory inputs for postural control. Methods Forty-two healthy adults stood on a balance board while wearing a virtual reality (VR) head-mounted display. The VR environment created a multisensory conflict amongst the different sensory signals as participants were tasked with maintaining postural stability on the balance board. Postural sway and scalp electroencephalography (EEG) were measured to assess visual weighting and cortical activity changes. Participants were randomized into groups that received different instructions on where to focus their attention during the balance task. Results Following the instructions to direct attention toward the movement of the board (external focus group) was associated with lower visual weighting and better balance performance than when not given any instructions on attentional focus (control group). Following the instructions to direct attention towards movement of the feet (internal focus group) did not lead to any changes in visual weighting or balance performance. Both external and internal focus groups exhibited increased EEG alpha power (8–13 Hz) activity over the occipital cortex as compared to the control group. Conclusions Current results suggest that directing one’s attention externally, away from one’s body, may optimize sensory integration for postural control when visual inputs are incongruent with somatosensory and vestibular inputs. Current findings may be helpful for clinicians and researchers in developing strategies to improve sensorimotor mechanisms for balance.

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An external focus of attention compared to an internal focus of attention improves anticipatory postural adjustments among people post-stroke

Cited by 8 publications

References 27 publications

Corticospinal Excitability of the Lower Limb Muscles During the Anticipatory Postural Adjustments: A TMS Study During Dart Throwing

Corticospinal Excitability of the Lower Limb Muscles During the Anticipatory Postural Adjustments: A TMS Study During Dart Throwing

External and internal focus of attention differentially modulate corticospinal excitability in anticipatory postural adjustments

The impact of external and internal focus of attention on visual dependence and EEG alpha oscillations during postural control

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