Randomized Trial on the Effects of Attentional Focus on Motor Training of the Upper Extremity Using Robotics With Individuals After Chronic Stroke

Hinojosa, Jim; Rao, Ashwini K.; Batavia, Mitchell; O’Dell, Michael W.

doi:10.1016/j.apmr.2017.06.005

Cited by 21 publications

(24 citation statements)

References 42 publications

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“…13 studies finally satisfied the inclusion criteria. Considering patients with CNS disorders [45][46][47][48][49][50][51][52][53][54] and patients with MSK disorders [55][56][57]. The PRISMA flow diagram representing the screening process is reported in Figure 1.…”

Section: Study Selectionmentioning

confidence: 99%

“…Considering the participants' sample, one RCT and four q-RCT enrolled 150 people with sub-acute stroke [45,[49][50][51]54], one q-RCT enrolled 28 people with acute stroke [53], one RCT and three q-RCT enrolled 79 people with Idiopathic Parkinson [46][47][48]52], a RCT enrolled 16 people after anterior cruciate ligament reconstruction (ACL) [57] and two RCT enrolled 76 people with ankle sprain [55,56]. The sample size was limited in all the studies (16-42 subjects) and there were heterogeneous ages.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The studies compared verbal instructions that direct the focus externally with verbal instructions that direct the focus internally in these main tasks: balance task [46,47,52,55,56]; lateral body weight shift [50]; darts throw [48]; reach-to-grasp [45,49]; single leg stepping [51]; tracing a trajectory [53,54]; single leg jump [57]. On average, the studies had duration of 1.54 days (range: 1-2 days) with 27 repetitions (range: 3-96 repetitions).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…On average, the studies had duration of 1.54 days (range: 1-2 days) with 27 repetitions (range: 3-96 repetitions). Only one study presented a longer duration (28 days) and a higher number of repetitions (max 960) [54].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Outcomes considering the kinematic and kinetic variables were peak elbow extension, peak shoulder flexion and peak trunk flexion [49], knee flexion angle at initial contact, peak knee flexion angle, flexion range of motion (ROM), knee valgus angle at initial contact, peak knee valgus angle, valgus ROM [57], joint independence [54].…”

Section: Study Characteristicsmentioning

confidence: 99%

See 4 more Smart Citations

Effect of Attentional Focus Instructions on Motor Learning and Performance of Patients with Central Nervous System and Musculoskeletal Disorders: a Systematic Review

Piccoli¹,

Rossettini²,

Cecchetto

et al. 2018

JFMK

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Exercise is one of the main rehabilitative interventions, commonly used to improve performance and motor learning. During the application of attentional focus strategies, External Focus of Attention (EFA) aiming at the movement effect has been reported to have more efficacy than Internal Focus of Attention (IFA) aiming at movement characteristics in healthy subjects. There are not many studies that compare the EFA and IFA instructions in people with Musculoskeletal (MSK) and Central Nervous System disorders (CNS). The purpose of this systematic review is to determine if IFA or EFA, in patients with CNS or MSK, may improve performance and have some effects on motor learning. Databases used for research: PubMed, CINAHL, Cochrane Library, PEDro, PsycINFO, SCOPUS. Inclusion criteria: Randomized Controlled Trial, quasi-Randomized Controlled Trial, enrolled subjects with CNS or with MSK and compared the efficacy of EFA and IFA. The studies suggest that the EFA is better than IFA in affecting the movement execution in patients with MSK, while conflicted findings emerge in presence of CNS disorders. Studies included in the qualitative analysis showed heterogeneous methodological features in study design and conductance, so results must be interpreted with caution.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Effect of Attentional Focus Instructions on Motor Learning and Performance of Patients with Central Nervous System and Musculoskeletal Disorders: a Systematic Review

Piccoli¹,

Rossettini²,

Cecchetto

et al. 2018

JFMK

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Care Should Be Exercised When Titling Articles So as to Not Mislead Readers

Callahan

2018

Archives of Physical Medicine and Rehabilitation

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Response From the Authors

Hinojosa

Rao

Batavia

et al. 2018

Archives of Physical Medicine and Rehabilitation

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Objective: To compare the long-term effects of external focus (EF) and internal focus (IF) of attention after 4 weeks of arm training. Design: Randomized, repeated-measures, mixed analysis of variance. Setting: Outpatient clinic. Participants: Individuals with stroke and moderate-to-severe arm impairment living in the community (NZ33; withdrawals: nZ3). Interventions: Four-week arm training protocol on a robotic device (12 sessions). Main Outcome Measures: Joint independence, Fugl-Meyer Assessment, and Wolf Motor Function Test measured at baseline, discharge, and 4-week follow-up. Results: There were no between-group effects for attentional focus. Participants in both groups improved significantly on all outcome measures from baseline to discharge and maintained those changes at 4-week follow-up regardless of group assignment (joint independence EF condition: F Conclusions: There were no differences in retention of motor skills between EF and IF participants 4 weeks after arm training, suggesting that individuals with moderate-to-severe arm impairment may not experience the advantages of an EF found in healthy individuals. Attentional focus is most likely not an active ingredient for retention of trained motor skills for individuals with moderate-to-severe arm impairment, whereas dosage and intensity of practice appear to be pivotal. Future studies should investigate the long-term effects of attentional focus for individuals with mild arm impairment.

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Randomized Trial on the Effects of Attentional Focus on Motor Training of the Upper Extremity Using Robotics With Individuals After Chronic Stroke

Abstract: Objective: To compare the long-term effects of external focus (EF) and internal focus (IF) of attention after 4 weeks of arm training.

Cited by 21 publications

References 42 publications

Effect of Attentional Focus Instructions on Motor Learning and Performance of Patients with Central Nervous System and Musculoskeletal Disorders: a Systematic Review

Effect of Attentional Focus Instructions on Motor Learning and Performance of Patients with Central Nervous System and Musculoskeletal Disorders: a Systematic Review

Care Should Be Exercised When Titling Articles So as to Not Mislead Readers

Response From the Authors

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