Department of Physical Education and Kinesiology, Brock University, 500 Glenridge Avenue, St. Catharines, Ontario, Canada.
Gait Posture. 2011 Jan;33(1):119-23. doi: 10.1016/j.gaitpost.2010.10.087. Epub 2010 Nov 19.
Previous research has shown that skill focused attention may be beneficial for the performance of complicated motor tasks in individuals with Parkinson's disease (PD). The objective of this study was to assess the impact of skill focused attention instructions on gait under temporal movement constraints that may reflect common challenges experienced in daily life. Eighteen patients with PD walked a straight pathway under two different attention focus conditions (no instruction, skill focused instruction) and two different walking speeds (preferred pace, as fast as possible). In the no instruction condition, patients were not told "where" attention should be directed. In the skill focused instruction condition, patients were told to focus on the foot contacting the floor with each step. Spatial and temporal gait measures, as well as, trunk sway were used to quantify walking performance. The results showed that when walking at a preferred pace, skill focused instructions benefited gait performance (e.g., increased gait velocity, larger steps, more trunk sway). However, when walking as fast as possible, skill focused instructions had the opposite effect on gait performance (e.g., decreased gait velocity, smaller steps, and less trunk sway). This study demonstrates that skill focused instructions may contribute to the prioritization of stability under imposed temporal movement constraints. Clinicians should be aware of the processes involved in prioritization of movement components versus task goals in PD and the potential application of an attention based instructional set in altering priorities in this population.
先前的研究表明，技能聚焦注意力可能有益于帕金森病（PD）患者完成复杂的运动任务。本研究的目的是评估在可能反映日常生活中常见挑战的时间运动限制下，技能聚焦注意力指导对步态的影响。18 名 PD 患者在两种不同的注意力集中条件（无指导、技能聚焦指导）和两种不同的步行速度（首选速度、尽可能快）下走直线路径。在无指导条件下，未告知患者注意力应集中在何处。在技能聚焦指导条件下，患者被要求专注于每一步脚接触地面。使用时空步态测量和躯干摆动来量化行走表现。结果表明，当以首选速度行走时，技能聚焦指导有益于步态表现（例如，增加步速、更大的步幅、更大的躯干摆动）。然而，当尽可能快地行走时，技能聚焦指导对步态表现产生相反的影响（例如，步速降低、步幅减小、躯干摆动减少）。本研究表明，技能聚焦指导可能有助于在施加的时间运动限制下优先考虑稳定性。临床医生应该意识到 PD 中运动成分与任务目标的优先级确定过程，以及基于注意力的指导方案在改变该人群优先级方面的潜在应用。
