Getting Focused
Focusing Attention on Outcome, Not Body Movement, Improved Stability Among Parkinson's Patients
People with Parkinson's disease can improve stability, and ultimately incur fewer falls, simply by changing their focus of attention, according to a recent study.
Two thirds of the estimated 1 million Americans that have Parkinson's disease reported falling in the last year.
"For those with a history of falls, it's much more effective to focus attention on the effects their movements have on the environment rather than focusing internally on the movements themselves," said Gabriele Wulf, kinesiology professor.
This study's findings could improve the rehabilitation techniques with Parkinson's patients. More importantly, the findings could give the patients more control over their lives by allowing them to more safely and effectively manage their posture and movement activities, Wulf said.
Motor Function and Learning Affected
Wulf and her research team had a group of 14 older adults with diagnosed Parkinson's disease balance on an inflated rubber disk. Participants were instructed to look straight ahead and focus on one of two things:
- reducing movements of their feet (internal focus)
- reducing movement of the disk (external focus)
Another group was not given attentional focus instructions.
Parkinson's patients experience degeneration in the part of the brain that controls motor function and learning. Instructions directing attention to the outcome of the movement support a more automatic form of motor control, consistent with that seen in expert performers.
"For example, beginning ice skaters focus all of their attention inward on their movements and adopt a stiff posture just to maintain balance. For experts, skating comes naturally and they're able to focus attention on the environment around them," Wulf said. "Similarly in rehabilitation, we've found that directing attention externally, in this case keeping the rubber disk they're standing on as still as possible, allows automatic control processes to kick in and tasks are performed more efficiently."
Study participants were tested in their homes one hour after taking their medication. Each participant performed four, 15-second trials of each condition.
Study Team
Wulf has conducted numerous studies on the effectiveness of external focus on a variety of motor skills, leading to improved performance in golf, tennis, volleyball, and soccer, as well practical applications in physical and occupational therapy.
This study appears in the February 2009 issue of Physical Therapy. It was co-authored by:
- Merrill Landers, professor of physical therapy
- Rebecca Lewthwaite, director of research and education in physical therapy for Rancho Los Amigos National Rehabilitation Center
- Thomas Töllner, assistant professor of neurocognitive psychology at Ludwig-Maximilians University in Munich, Germany
Related Information
Physical Therapy journal
Gabriele Wulf
Department of Kinesiology and Nutrition Sciences
Merrill Landers
Department of Physical Therapy
