Dynamic Balance in Parkinson´s Disease Can be Ameliorated by External Focus of Attention

Abstract

Most studies on balance training in individuals with Parkinson´s disease (PD) reported ambiguous effects. Therefore the study aimed to investigate the effect of an attentional focus and severity of PD on dynamic balance. In the study, 31 patients with idiopathic PD in stage I-III, aged 69.6 ± 6.6 years, performed the five times sit-to-stand (FTSS) task two times in each of three conditions: control, i.e., with no attentional focus instruction, the external focus of attention (IFA) induced by the instruction: „concentrate on quick movement of shoulders up and down“, and external focus of attention (EFA) induced by the instruction: „ concentrate on quick movement of the tape markers up and down“ (the markers glued on one´s shoulders). As a result, the FTSS time was shorter and the number of symptoms of imbalance manifested during performing of the task was lower in the EFA condition as compared to control and IFA conditions. No significant interaction between the focus of attention and severity of PD operationalized as the Hoehn and Yahr´s PD stage and the risk of falls suggested the generalizability of the effect of focus of attention on dynamic balance across the PD stages I-III and regardless of whether moderate risk of falls or no risk in PD patients. This study also provided evidence that these individuals with PD can adopt task-specific instructions to perform movement skills.