Immediate effects of two attention strategies on trunk control on patients after stroke. A randomized controlled pilot trial

Abstract

Objective: To compare the immediate effects of an external focus to enhance lateral body weight shift after stroke.

Design: Randomized controlled trial.

Setting: Inpatient rehabilitation hospital.

Subjects: Twenty patients after stroke (11 males; mean (SD) age 72.2 (7.4) years; duration of illness 56 (14) days; there were 9 (45%) left-sided strokes) with impaired sitting balance were randomly allocated into two groups either external focus (n = 10) or internal focus (n = 10).

Intervention: Patients in the external focus group, while sitting, were instructed to shift as much weight as they could sidewards to an external point next to their hip. Patients in the internal focus group were instructed to shift as much weight as they could sidewards to their hip.

Main outcome measures: Immediate lateral body weight shift as well as anterior-posterior deviation was measured in centimetres with a sensor mat.

Results: Patients in the external focus group achieved greater lateral body weight shift than those in the internal focus group (mean shift (SD) 8.7 (2.6) cm vs. 4.5 (3.3) cm, respectively; P = 0.006). However, there were no significant differences in anterior-posterior deviation (mean shift (SD) 2.3 (1.3) cm vs. 1.2 (1.2) cm, respectively; P = 0.08).

Conclusion: Using an external focus may lead immediately to an enhanced lateral body weight shift while sitting, without increasing anterior-posterior deviation.

Keywords: Stroke; focus of attention; physiotherapy; rehabilitation.