ORIGINAL ARTICLE How physical therapists instruct patients with stroke: an observational study onattentional focus during gait rehabilitation after stroke

Well, NO reporting on the actual results from this. So completely useless.

How physical therapists instruct patients with stroke: an observational study on attentional focus during gait rehabilitation after stroke

Elmar Kal, Henrieke van den Brink, Han Houdijk, John van der Kamp, PaulienHelena Goossens, Coen van Bennekom & Erik Scherder

To cite this article:

 Elmar Kal, Henrieke van den Brink, Han Houdijk, John van der Kamp, PaulienHelena Goossens, Coen van Bennekom & Erik Scherder (2017): How physical therapists instructpatients with stroke: an observational study on attentional focus during gait rehabilitation after stroke, Disability and Rehabilitation, DOI: 10.1080/09638288.2017.1290697

To link to this article:

http://dx.doi.org/10.1080/09638288.2017.1290697

Elmar Kal, Henrieke van den Brink, Han Houdijk, John van der Kamp, Paulien Helena Goossens, Coen van Bennekom & show all

Pages 1154-1165 | Received 20 Jul 2016, Accepted 31 Jan 2017, Published online: 24 Feb 2017

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Abstract

Purpose: People without neurological impairments show superior motor learning when they focus on movement effects (external focus) rather than on movement execution itself (internal focus). Despite its potential for neurorehabilitation, it remains unclear to what extent external focus strategies are currently incorporated in rehabilitation post-stroke. Therefore, we observed how physical therapists use attentional focus when treating gait of rehabilitating patients with stroke.
Methods: Twenty physical therapist-patient couples from six rehabilitation centers participated. Per couple, one regular gait-training session was video-recorded. Therapists’ statements were classified using a standardized scoring method to determine the relative proportion of internally and externally focused instructions/feedback. Also, we explored associations between therapists’ use of external/internal focus strategies and patients’ focus preference, length of stay, mobility, and cognition.
Results: Therapists’ instructions were generally more external while feedback was more internal. Therapists used relatively more externally focused statements for patients with a longer length of stay (B = −0.239, p = 0.013) and for patients who had a stronger internal focus preference (B = −0.930, p = 0.035).
Conclusions: Physical therapists used more external focus instructions, but more internally focused feedback. Also, they seem to adapt their attentional focus use to patients’ focus preference and rehabilitation phase. Future research may determine how these factors influence the effectiveness of different attentional foci for motor learning post-stroke.