Award Date

5-1-2024

Degree Type

Doctoral Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Committee Member

Daniel Young

Second Committee Member

Szu-Ping Lee

Third Committee Member

Merrill Landers

Number of Pages

38

Abstract

Background and Purpose: Chronic diabetes is a prevalent systemic disease that impairs physical functioning and often leads to increased risk of falls. Adopting an external focus of attention during motor skill practice has been shown to improve learning outcomes, however, it has not been examined in this population. We examined how attentional focus instructions (internal vs. external) affect balance performance and learning in older adults with and without diabetes.

Methods: Fifty-three older adults (27 with diabetes, 63.7±7.0 years) participated in the randomized, pre-post intervention study. The balance training involved 50 practice trials of a stabilometer task that was novel to all participants. Participants were randomized to receive either internal or external focus task instruction. Task performances were assessed at baseline, during training, and during a retention test. Primary outcomes were changes in balance task performance before and after training. The study protocol was approved by the UNLV Biomedical IRB, and participants gave written consent prior to data collection.

Results: Participants who received external focus instruction showed significantly greater increase in balance performance than individuals who received internal focus instruction (95% CI=[0.02; 4.05], p=0.048). While participants with diabetes exhibited poorer baseline task performance (p=0.02), both groups improved their relative task performance after training (95% CI=[5.25; 18.14], p<0.0001).

Discussion and Conclusions: Adopting an external focus of attention benefits performance during short-term training of a novel balance task in older adults with and without diabetes. Participants with diabetes were capable of improving task performance with practice at a relative rate similar to those without diabetes. This information may be useful for designing interventional strategies to improve physical function and mitigate fall risks in older adults with diabetes.

Keywords

Balance; Attentional focus; Motor learning; Older adults; Diabetes; Falls

Disciplines

Medicine and Health Sciences | Physical Therapy | Rehabilitation and Therapy

File Format

pdf

File Size

749.96 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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