The effects of anxiety and external attentional focus on postural control in patients with Parkinson's disease

Jazaeri, Seyede Zohreh; Azad, Akram; Mehdizadeh, Hajar; Habibi, Seyed Amirhassan; Najafabadi, Mahbubeh Mandehgary; Saberi, Zakieh Sadat; Rahimzadegan, Hawre; Moradi, Saeed; Behzadipour, Saeed; Parnianpour, Mohamad; Taghizadeh, Ghorban; Khalaf, Kinda

doi:10.1371/journal.pone.0192168

Cited by 29 publications

(18 citation statements)

References 39 publications

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“…Concerning the scale's reliability, the present study suggested an acceptable internal consistency of the FES, which is in line with previous studies (α= 0.75-0.98) in elder adults [7,[10][11][12][22][23][24][25][26]. Therefore, this scale's items cover all aspects of FOF.…”

Section: Discussionsupporting

confidence: 90%

The Psychometric Properties of Falls Efficacy Scale in the Elderly Iranian Residents of Nursing Homes

Fadavi-Ghaffari¹,

Azad²,

Meimandi³

et al. 2019

Iran. Rehabil. J.

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The elderly residents of nursing homes experience falling at least once a year. The fear of falling influences the quality of life and causes limitations in their daily living activities. Therefore, this study aimed to translate the Falls Efficacy Scale (FES) and investigate its validity and reliability in the elderly Iranian residents of nursing homes. Methods: The current methodological study was conducted on 100 healthy 60-87 years older adults in Tehran City, Iran. The subjects were selected by convenience sampling method. The translation was conducted using forward-backward procedure. The face and content validities of the scale were determined by impact score, Content Validity Index (CVI), and Content Validity Ratio (CVR). We established the construct validity by Exploratory Factor Analysis (EFA), applying principal component analysis by varimax rotation. The scale's convergent validity was examined using the Spearman correlation coefficient with the Falls Efficacy Scale-International (FES-I) and Single Item Question (SIQ). Cronbach's α and Intra-Class Correlation (ICC) were calculated to investigate the scale's internal consistency and test-retest reliability. There were 4-7 days of interval for assessing the test-retest reliability. Results: The CVR and CVI of all items were greater than 0.57 and 0.79, respectively. The obtained results suggested an impact score higher than 1.5 for each item. The EFA results indicated two factors in the FES. Convergent validity revealed very high to high correlation between the FES and FES-I (rho=0.92, P<0.0001), and SIQ (rho=0.72, P<0.0001). Excellent internal consistency (α=0.95) and test-retest reliability (ICC=0.98) were reported for the scale. Discussion: The obtained results indicated that the original version of FES was a reliable and valid tool for assessing the fear of falling among the elderly residents of nursing homes.

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Section: Discussionsupporting

confidence: 90%

The Psychometric Properties of Falls Efficacy Scale in the Elderly Iranian Residents of Nursing Homes

Fadavi-Ghaffari¹,

Azad²,

Meimandi³

et al. 2019

Iran. Rehabil. J.

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“…In our results, different explanations could have contributed to no significant changes under dual-task. First, the cognitive task provides an external focus which diverts attention from body sways and reduces conscious control [ 39 ]. Some studies have shown the potential of external focus to reduce postural instability during quiet standing compared to an internal focus in pwPD [ 40 ] and to improve postural instability when pwPD took dopamine medication [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of a Concurrent Cognitive Task, with Stabilizing Visual Information and Withdrawal, on Body Sway Adaptation of Parkinsonian’s Patients in an Off-Medication State: A Controlled Study

Delafontaine

Hansen

Marolleau

et al. 2020

Sensors

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Background: In persons with Parkinson’s disease (pwPD) any additional somatosensory or distractor interference can influence the posture. When deprivation of vision and dual-task are associated, the effect on biomechanical performance is less consistent. The aim of this study was to evaluate the role of the visual deprivation and a cognitive task on the static balance in earlier stage PD subjects. Methods: Fifteen off-medication state pwPD (9 women and 6 men), 67.7 ± 7.3 years old, diagnosed PD since 5.4 ± 3.4 years, only Hoehn and Yahr state 2 and fifteen young control adults (7 women and 8 men) aged 24.9 ± 4.9 years, performed semi-tandem task under four randomized experimental conditions: eyes opened single-task, eyes closed single-task, eyes opened dual-task and eyes closed dual-task. The center of pressure (COP) was measured using a force plate and electromyography signals (EMG) of the ankle/hip muscles were recorded. Traditional parameters, including COP pathway length, ellipse area, mediolateral/anteroposterior root-mean-square and non-linear measurements were computed. The effect of vision privation, cognitive task, and vision X cognitive was investigated by a 2 (eyes opened/eyes closed) × 2 (postural task alone/with cognitive task) repeated-measures ANOVA after application of a Bonferroni pairwise correction for multiple comparisons. Significant interactions were further analyzed using post-hoc tests. Results: In pwPD, both COP pathway length (p < 0.01), ellipse area (p < 0.01) and mediolateral/anteroposterior root-mean-square (p < 0.01) were increased with the eyes closed, while the dual-task had no significant effect when compared to the single-task condition. Comparable results were observed in the control group for who COP pathway was longer in all conditions compared to eyes opened single-task (p < 0.01) and longer in conditions with eyes closed compared to eyes opened dual-task (p < 0.01). Similarly, all differences in EMG activity of pwPD were exclusively observed between eyes opened vs. eyes closed conditions, and especially for the forward leg’s soleus (p < 0.01) and backward tibialis anterior (p < 0.01). Conclusions: These results in pwPD without noticeable impairment of static balance encourage the assessment of both visual occlusion and dual-task conditions when the appearance of significant alteration during the dual-task could reveal the subtle worsening onset of the balance control.

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“…Automaticity could have been enhanced by an external focus of attention, an idea known as the “constrained action hypothesis” (Wulf et al, 2001; Kal et al, 2013), employed for the reduction of cognitive interference in athletic performance. Maintaining an external focus of attention, like a target or an image, has been shown to be an effective strategy in improving postural control in patients with PD (Wulf et al, 2009; Jazaeri et al, 2018), however no data has been reported on the effects of an external focus on dual task or gait performance. In dance practice, the use of metaphors may serve the purpose of directing attention externally to produce a movement through the use of imagery (Guss-West and Wulf, 2016; Lewthwaite and Wulf, 2017).…”

Section: Discussionmentioning

confidence: 99%

Beauty That Moves: Dance for Parkinson’s Effects on Affect, Self-Efficacy, Gait Symmetry and Dual Task Performance

Fontanesi

DeSouza

2020

Preprint

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BackgroundPrevious studies have investigated the effects of dance interventions on Parkinson’s motor and non-motor symptoms in an effort to develop an integrated view of dance as a therapeutic intervention. This within-subject study questions whether dance can be simply considered a form of exercise by comparing a Dance for Parkinson’s class with a matched-intensity exercise session lacking dance elements like music, metaphorical language, and social reality of grace and beauty.MethodsIn this repeated-measure design, 7 adults with Parkinson’s were tested four times; (i) before and (ii) after a Dance for Parkinson’s class, as well as (iii) before and (iv) after a matched-intensity exercise session. Physiological measures included heart rate and electrodermal activity. Self-reported affect and body self-efficacy were collected. Gait symmetry and dual task cost were analyzed using the 6-minutes walking test (6MWT) and Timed-Up-and-Go test (TUG), respectively.ResultsAverage heart rate was the same for both conditions, while electrodermal activity was higher during Dance for Parkinson’s. Significant differences were found in body self-efficacy, beauty subscale, symmetry of gait, and dual task performance.ConclusionsDance, compared to an exercise intervention of matched intensity, yields different outcomes through the means of intrinsic artistic elements, which may influence affective responses, the experience of beauty, self-efficacy, and gait performance.

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The effects of anxiety and external attentional focus on postural control in patients with Parkinson's disease

Cited by 29 publications

References 39 publications

The Psychometric Properties of Falls Efficacy Scale in the Elderly Iranian Residents of Nursing Homes

The Psychometric Properties of Falls Efficacy Scale in the Elderly Iranian Residents of Nursing Homes

Effect of a Concurrent Cognitive Task, with Stabilizing Visual Information and Withdrawal, on Body Sway Adaptation of Parkinsonian’s Patients in an Off-Medication State: A Controlled Study

Beauty That Moves: Dance for Parkinson’s Effects on Affect, Self-Efficacy, Gait Symmetry and Dual Task Performance

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