Landers, M, Wulf, G, Wallmann, H, Guadagnoli, M; College of Health Sciences, Departments of Physical Therapy and Kinesiology, University of Nevada, Las Vegas, Las Vegas, NV, USA. Merrill.Landers@ccmail.nevada.edu.

PURPOSE: Studies have shown that motor skill acquisition can be enhanced by directing the performer’s attention to the effects of their movements on the environment (external focus), compared to directing attention to the movements themselves (internal focus), and conditions without attentional focus instructions. Advantages to using external focus instructions have been found for a variety of motor skills, including static and dynamic balance. Previous studies have exclusively used young adults with no known impairment. The purpose of this study was to investigate the generalizability of these findings to those with Parkinson’s disease (PD). SUBJECTS: Ten subjects (mean age = 72.5 years) with Hoehn and Yahr Stage III PD without a history of dementia were recruited to participate in this study. All subjects reported a history of falls (>1) within the last year. METHODS: Subjects were tested under three conditions on the NeuroCom Smart^® Balance Master System (Balance Master), Condition 1 (static), Condition 2 (static, eyes closed), and Condition 4 (sway referenced). Three attentional focus instruction conditions, Condition A (no instruction), Condition B (internal focus), Condition C (external focus) were then tested for each of the Balance Master conditions. Condition A was performed first and Conditions B and C were counter-balanced. ANALYSES AND RESULTS: A 3 (condition) x 3 (attentional focus) ANOVA yielded a significant condition x attentional focus interaction (F=4.4; p=.005). Post-hoc analyses for Condition 4 (sway referenced) revealed a main effect of attentional focus (F=4.4; p=.027). The external focus instructions yielded higher scores (i.e., resulted in less sway) than both no attentional focus instructions (p=.045) and internal focus instructions (p=.030). CONCLUSIONS: These findings support previous research that suggests that motor performance can be enhanced by giving external focus instructions. In particular, it was demonstrated that patients with PD and a fall history performed better on a sway referenced balance task when given external focus instructions versus either no focus instructions or internal focus instructions. These results support the notion that instructions for motor skill acquisition should focus on the effects of the movement rather than the movement itself. FUNDING SOURCES: Departments of Physical Therapy and Kinesiology at the University of Nevada, Las Vegas.

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