The role of attentional focus on walking efficiency among older fallers and non-fallers

Toby C.T. Mak, William R. Young, Wing Kai Lam, Andy C.Y. Tse, Thomson W.L. Wong (Corresponding Author)

Research output: Journal article publicationJournal articleAcademic researchpeer-review

3 Citations (Scopus)

Abstract

Background: This study evaluated the effect of attentional focus instructions on movement efficiency during a level-ground walking task in older adults with and without a history of falls. Methods: One hundred and thirty-four community-dwelling older adults were categorised into older fallers (OF) (n = 37) and older non-fallers (ONF) (n = 97). Each participant was instructed to walk at a self-selected pace along a 6 m walkway under three attentional focus conditions (i.e. internal, goal-directed and control) for a total of nine trials. Average muscle activity indices of lower limb co-contractions were measured using surface electromyography. Results: Both shank and thigh muscle co-contractions were higher in OF than in ONF in all three conditions. OF also demonstrated higher shank muscle co-contraction under the internal relative to the goal-directed condition, with no such change observed in ONF. Conclusion: Despite no significant between-group differences in functional balance and balance confidence, relative walking inefficiencies were observed in OF compared with ONF. This finding demonstrates the debilitating consequences of falling that can occur with relative independence from various physiological or psychological factors that are commonly associated with falling and used to rationalise behavioural change. We also provide evidence that OF are more susceptible to conditions that provoke them to allocate attention internally. Therefore, in clinical contexts (e.g. gait rehabilitation), verbal instructions that refer to body movements (internal focus) might serve to compromise movement efficiency in older adults with a history of falls. Such changes will, theoretically, lessen the ability to react efficiently to changing environments experienced in daily life.

Original languageEnglish
Pages (from-to)811-816
Number of pages6
JournalAge and Ageing
Volume48
Issue number6
DOIs
Publication statusPublished - 1 Nov 2019
Externally publishedYes

Keywords

  • attention
  • efficiency
  • falls
  • gait
  • muscle
  • older people

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this