Mak Toby C T, Wong Thomson W L, Leung Melody C Y, Wong Duo W C, Chan Debbie C L, Ng Shamay S M
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong S.A.R., China.
Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong S.A.R., China.
Psychol Res. 2025 Apr 23;89(3):95. doi: 10.1007/s00426-025-02122-3.
Few studies have adopted external focus strategies to mitigate the negative effects of conscious movement processing in older adults. We investigated whether a single-session intervention (SSI) using an external focus could improve gait stability and visual search behaviors during adaptive locomotion in older adults.
We randomly allocated 112 older adults to either an external focus (EXT, n = 56) or a control group (CON, n = 56). Participants performed an obstacle circumvention walking task along an 8-m walkway for five trials at pre-intervention (T0), post-intervention (T1), and retention (T2). The training phase consisted of 20 walking trials with obstacle circumvention. EXT focused on digits displayed on monitors at their path destinations during walking, while CON walked naturally without any specific instructions. Gait kinematics (i.e., gait variabilities and body sway) and visual search data were collected at T0, T1, and T2.
Only EXT reduced body sway and variability of spatial and temporal gait parameters, while increasing gait speed when comparing T1 and T2 to T0. EXT also reduced the number of visual fixation and fixation duration percentage on the ground while increasing fixation duration percentage on the destination when comparing T1 and T2 to T0.
This study is the first to explore SSI with an external focus in older adults, providing evidence of significant improvements in gait stability and visual search behaviors that facilitate feedforward planning. Practicing with an external focus strategy could be recommended as an adjunctive psychomotor approach in clinical settings to enhance visuomotor performance in older adults.
很少有研究采用外部聚焦策略来减轻老年人有意识运动处理的负面影响。我们调查了使用外部聚焦的单节段干预（SSI）是否能改善老年人适应性行走过程中的步态稳定性和视觉搜索行为。
我们将112名老年人随机分配到外部聚焦组（EXT，n = 56）或对照组（CON，n = 56）。参与者在干预前（T0）、干预后（T1）和保持期（T2）沿着8米长的走道进行五次绕过障碍物的步行任务试验。训练阶段包括20次绕过障碍物的步行试验。EXT组在行走时专注于路径终点显示器上显示的数字，而CON组自然行走，没有任何特定指示。在T0、T1和T2收集步态运动学（即步态变异性和身体摆动）和视觉搜索数据。
与T0相比，仅EXT组在比较T1和T2时减少了身体摆动以及空间和时间步态参数的变异性，同时提高了步态速度。与T0相比，EXT组在比较T1和T2时还减少了对地面的视觉注视次数和注视持续时间百分比，同时增加了对终点的注视持续时间百分比。
本研究首次在老年人中探索了具有外部聚焦的SSI，为步态稳定性和促进前馈计划的视觉搜索行为显著改善提供了证据。在临床环境中，推荐采用外部聚焦策略进行练习，作为一种辅助性心理运动方法，以提高老年人的视觉运动表现。
