Article

OBJECTIVE: To compare the long-term effects of external focus (EF) and internal
focus (IF) of attention after 4 weeks of arm training.
DESIGN: Randomized,
repeated-measures, mixed analysis of variance.
SETTING: Outpatient clinic.
PARTICIPANTS: Individuals with stroke and moderate-to-severe arm impairment
living in the community (N=33; withdrawals: n=3). INTERVENTIONS: Four-week arm
training protocol on a robotic device (12 sessions). MAIN OUTCOME MEASURES: Joint
independence, Fugl-Meyer Assessment, and Wolf Motor Function Test measured at
baseline, discharge, and 4-week follow-up. RESULTS: There were no between-group
effects for attentional focus. Participants in both groups improved significantly
on all outcome measures from baseline to discharge and maintained those changes
at 4-week follow-up regardless of group assignment (joint independence EF
condition: F1.6,45.4=17.74; P<.0005; partial eta(2)=.39; joint independence IF
condition: F2,56=18.66; P<.0005; partial eta(2)=.40; Fugl-Meyer Assessment:
F2,56=27.83; P<.0005; partial eta(2)=.50; Wolf Motor Function Test: F2,56=14.05;
P<.0005; partial eta(2)=.35). CONCLUSIONS: There were no differences in retention
of motor skills between EF and IF participants 4 weeks after arm training,
suggesting that individuals with moderate-to-severe arm impairment may not
experience the advantages of an EF found in healthy individuals. Attentional
focus is most likely not an active ingredient for retention of trained motor
skills for individuals with moderate-to-severe arm impairment, whereas dosage and
intensity of practice appear to be pivotal. Future studies should investigate the
long-term effects of attentional focus for individuals with mild arm impairment.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS