External focus improves postural stability in Parkinson’s disease patients

March 27th, 2009 - 5:07 pm ICT by ANI  

Washington, Mar 27 (ANI): Parkinson’s disease patients can improve their postural stability by directing their attention to the external effects of their movements, instead of focussing on movements of their own body, according to a new study.

Adults with Parkinson disease are at greater risk for posture and balance impairments, which may lead to falls and resultant head injuries and fractures. Such injuries may finally lead to hospitalisation, and further mobility limitations.

“Of the major motor signs of Parkinson disease, postural instability is the least responsive to medication. It is crucial that physical therapists continue to develop effective rehabilitation strategies to address this issue,” said physical therapist researcher and APTA spokesperson Merrill Landers, who also worked on this study.

Led by Dr. Gabriele Wulf, the researchers observed 14 adults with idiopathic Parkinson disease as they balanced on an unstable surface (an inflated rubber disk) under three attentional focus conditions — external focus, internal focus, and a control condition.

The researchers told the patients to either focus on reducing movements of the rubber disk (external focus) or movements of their feet (internal focus), or they did not give them attentional focus instructions (control condition).

The findings came in line with previous research on attention focus, which showed that during standing for Parkinson’s disease patients, directing attention to the effects of an individual’s movement on the environment (external focus) improved postural stability, compared with internal focus and control conditions.

“In the past 12 years or so, numerous studies have been done - many of them involving healthy adults learning sport skills - and it has consistently been found that individuals perform and learn motor skills more effectively when they are instructed to adopt an external focus. Other studies have shown that those advantages generalize to people after stroke as well as to the rehabilitation of ankle sprains, for example. This is a very reliable effect, and the current study demonstrates that persons with Parkinson disease benefit from an external attentional focus as well,” explained Wulf.

“Findings from this study not only have the potential to enhance the rehabilitation strategies of physical therapists working with patients with Parkinson disease, but may ultimately give patients with postural instability more control over their lives through the use of strategies that help them manage their own balance safely and effectively,” said Rebecca Lewthwaite, PhD, of Rancho Los Amigos National Rehabilitation Center, a co-author on the study.

The study has been published in the journal Physical Therapy. (ANI)

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