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

Piccoli, Alessandro; Rossettini, Giacomo; Cecchetto, Simone; Viceconti, Antonello; Ristori, Diego; Turolla, Andrea; Maselli, Filippo; Testa, Marco

doi:10.3390/jfmk3030040

Cited by 41 publications

(42 citation statements)

References 72 publications

(242 reference statements)

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“…Potentially, the most worrying long-term outcome of CAI is the development of post-traumatic osteoarthritis 2 . Therefore, preventive initiatives are necessary to reduce the long-term consequences of these injuries 51 , and the first step towards progress in this area is to examine the walking features of these patients.…”

Section: Discussionmentioning

confidence: 99%

Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability

Tajdini

Mantashloo

Thomas

et al. 2022

Sci Rep

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After an initial ankle sprain, a relevant number of participants develop chronic ankle instability (CAI). Compensatory strategies in patients with CAI may change the inter-limb symmetry needed for absorbing movement-related forces. Accordingly, an increased risk of injury can occur. The present study aimed to compare the inter-limb asymmetry of kinetic and electromyography between individuals with CAI and without a history of an ankle sprain (Non-CAI) during walking. In this cross-sectional study, fifty-six athletes (28 CAI; 28 Non-CAI) participated. Participants walked at a comfortable pace over level ground while vertical ground reaction force (vGRF) and muscle activity of the tibialis anterior, peroneus longus, medial gastrocnemius, and gluteus medius were recorded. Inter-limb asymmetry during walking was calculated for each of the variables. Patients with CAI exhibited a greater inter-limb asymmetry of the first peak of vGRF, time to peak vGRF, and loading rate (P < 0.001), as well as presenting a greater inter-limb asymmetry of peroneus longus activity (contact phase) (P = 0.003) and gluteus medius activity (midstance/propulsion phase) (P = 0.010) compared to the Non-CAI group. No other differences in vGRF or muscles activity were observed between the groups. Our findings indicate that patients with CAI walk with greater inter-limb asymmetry in vGRF and muscle activity in different phases of the gait cycle compared to Non-CAI group. Our results could inform future studies on gait training aimed to reduce asymmetry during walking in patients with CAI.

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Section: Discussionmentioning

confidence: 99%

Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability

Tajdini

Mantashloo

Thomas

et al. 2022

Sci Rep

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“…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 ]. However, if we did not find significant difference due to the dual-task, confidence interval higher limit was higher for COP pathway and ellipse area under dual-task.…”

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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“…Trackers could be considered as real external focus of attention (EFA). Research reported that EFAs are more effective than internal focus of attention (IFA) in terms of motor performance and learning improvements (Rossettini et al 2017) (Piccoli et al 2018). Indeed, EFAs provide a higher level of movement efficacy and kinematics across different types of tasks, skill levels and age groups (Wulf 2013).…”

Section: Discussionmentioning

confidence: 99%

Robustness and static-positional accuracy of the SteamVR 1.0 virtual reality tracking system

et al. 2021

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The use of low-cost immersive virtual reality systems is rapidly expanding. Several studies started to analyse the accuracy of virtual reality tracking systems, but they did not consider in depth the effects of external interferences in the working area. In line with that, this study aimed at exploring the static-positional accuracy and the robustness to occlusions inside the capture volume of the SteamVR (1.0) tracking system. To do so, we ran 3 different tests in which we acquired the position of HTC Vive PRO Trackers (2018 version) on specific points of a grid drawn on the floor, in regular tracking conditions and with partial and total occlusions. The tracking system showed a high inter- and intra-rater reliability and detected a tilted surface with respect to the floor plane. Every acquisition was characterised by an initial random offset. We estimated an average accuracy of 0.5 ± 0.2 cm across the entire grid (XY-plane), noticing that the central points were more accurate (0.4 ± 0.1 cm) than the outer ones (0.6 ± 0.1 cm). For the Z-axis, the measurements showed greater variability and the accuracy was equal to 1.7 ± 1.2 cm. Occlusion response was tested using nonparametric Bland–Altman statistics, which highlighted the robustness of the tracking system. In conclusion, our results promote the SteamVR system for static measures in the clinical field. The computed error can be considered clinically irrelevant for exercises aimed at the rehabilitation of functional movements, whose several motor outcomes are generally measured on the scale of metres.

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

Cited by 41 publications

References 72 publications

Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability

Inter-limb asymmetry of kinetic and electromyographic during walking in patients with chronic ankle instability

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

Robustness and static-positional accuracy of the SteamVR 1.0 virtual reality tracking system

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