31 research outputs found

    Frailty, falls and poor functional mobility predict new onset of activity restriction due to concerns about falling in older adults: a prospective 12-month cohort study

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    Purpose: Concerns about falling are common in older adults and often cause activity restriction. This can lead to physical deconditioning, falls and social isolation. However, not every concerned older adult will restrict their activities. This 12-month longitudinal study investigated the physical and psychosocial factors that predict the new onset of activity restriction due to concerns about falling in older people. Methods: Participants were 543 older adults (M age = 80.3 ± 4.4 years, range: 75–98) who did not report activity restriction due to concerns about falling at Timepoint-1 (negative response to the following question: “Do concerns about falling stop you going out-and-about?”). Participants completed a battery of physical and psychological assessments at Timepoint-1. Using binary logistic regression, we then assessed which of these variables predicted whether participants reported having started restricting their activity due to concerns about falling at the 12-month follow-up (Timepoint 2). Results: 10.1% of the sample started to restrict activity due to concerns about falling at Timepoint 2. Three key predictors significantly predicted activity restriction group status at 12-month follow-up: greater frailty at Timepoint-1 (Fried Frailty Index; OR = 1.58, 95% CI 1.09–2.30), experiencing a fall between Timepoint-1 and 2 (OR = 2.22, 95% CI 1.13–4.38) and poorer functional mobility at Timepoint-1 (Timed up and Go; OR = 1.08, 95% CI 1.01–1.15). Conclusions: Frailty, experiencing a fall and poorer functional mobility all predicted the onset of activity restriction due to concerns about falling. Clinicians working in balance and falls-prevention services should regularly screen for frailty, and patients referred to frailty services should likewise receive tailored treatment to help prevent the development of activity restriction due to concerns about falling

    Consciously processing balance leads to distorted perceptions of instability in older adults

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    This is the final version. Available on open access from Springer Verlag via the DOI in this recordAvailability of data and materials: All analysed data is available via an Open Science Framework repository (https://osf.io/nvrky/?view_only=bcd27ccfe99c47feaff215173a76d2fc). Code availability: Custom MATLAB codes available from the lead author following reasonable request.Background: Persistent dizziness without a clear cause is common in older adults. We explored whether an anxiety-driven preoccupation with consciously processing balance may underpin the distorted perceptions of unsteadiness that characterises ‘unexplained’ dizziness in older adults. Methods: We experimentally induced anxiety about losing one’s balance (through a postural threat manipulation) in a cohort of asymptomatic older adults and evaluated associated changes in perceived stability, conscious movement processing and postural control. These outcomes were also assessed when performing a distracting cognitive task designed to prevent anxiety-related conscious movement processing, in addition to during baseline conditions (ground level). Results: Despite a lack of increase in postural sway amplitude (p = .316), participants reported reductions in perceived stability during postural threat compared to baseline (p < .001). A multiple linear regression revealed that anxiety-related conscious movement processing independently predicted perceptions of instability during this condition (p = .006). These changes were accompanied by alterations in postural control previously associated with functional dizziness, namely high-frequency postural sway and disrupted interaction between open- and closed-loop postural control (ps < .014). While the distraction task successfully reduced conscious processing (p = .012), leading to greater perceived stability (p = .010), further increases in both postural sway frequency (p = .002) and dominance of closed-loop control (p = .029) were observed. Conclusions: These findings implicate the role of conscious movement processing in the formation of distorted perceptions of unsteadiness, suggesting that such perceptions may be modifiable by reducing an over-reliance on conscious processes to regulate balance

    Focus of Attention in Children's Motor Learning: Examining the Role of Age and Working Memory

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    The authors investigated the relative effectiveness of different attentional focus instructions on motor learning in primary school children. In addition, we explored whether the effect of attentional focus on motor learning was influenced by children's age and verbal working memory capacity. Novice 8–9-year old children (n = 30) and 11–12-year-old children (n = 30) practiced a golf putting task. For each age group, half the participants received instructions to focus (internally) on the swing of their arm, while the other half was instructed to focus (externally) on the swing of the club. Children's verbal working memory capacity was assessed with the Automated Working Memory Assessment. Consistent with many reports on adult's motor learning, children in the external groups demonstrated greater improvements in putting accuracy than children who practiced with an internal focus. This effect was similar across age groups. Verbal working memory capacity was not found to be predictive of motor learning, neither for children in the internal focus groups nor for children in the external focus groups. In conclusion, primary school children's motor learning is enhanced by external focus instructions compared to internal focus instructions. The purported modulatory roles of children's working memory, attentional capacity, or focus preferences require further investigation

    Over-focused? The relation between patients’ inclination for conscious control and single- and dual-task motor performance after stroke

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    Background: Many stroke patients are inclined to consciously control their movements. This is thought to negatively affect patients’ motor performance, as it disrupts movement automaticity. However, it has also been argued that conscious control may sometimes benefit motor performance, depending on the task or patientś motor or cognitive capacity. Aim: To assess whether stroke patients’ inclination for conscious control is associated with motor performance, and explore whether the putative association differs as a function of task (single- vs dual) or patientś motor and cognitive capacity. Methods: Univariate and multivariate linear regression analysis were used to assess associations between patients’ disposition to conscious control (i.e., Conscious Motor Processing subscale of Movement-Specific Reinvestment Scale; MSRS-CMP) and single-task (Timed-up-and-go test; TuG) and motor dual-task costs (TuG while tone counting; motor DTC%). We determined whether these associations were influenced by patients’ walking speed (i.e., 10-m-walk test) and cognitive capacity (i.e., working memory, attention, executive function). Results: Seventy-eight clinical stroke patients (<6 months post-stroke) participated. Patients’ conscious control inclination was not associated with single-task TuG performance. However, patients with a strong inclination for conscious control showed higher motor DTC%. These associations were irrespective of patients’ motor and cognitive abilities. Conclusion: Patients’ disposition for conscious control was not associated with single task motor performance, but was associated with higher motor dual task costs, regardless of patients’ motor or cognitive abilities. Clinical relevance: Therapists should be aware that patients’ conscious control inclination can influence their dual-task performance while moving. Longitudinal studies are required to test whether reducing patients’ disposition for conscious control would improve dual-tasking post-stroke

    Standing up to threats: Translating the two-system model of fear to balance control in older adults

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    © 2021 The Authors. The ‘two-system’ view of fear builds on traditional conceptualisations of emotion; proposing that the mechanism(s) responsible for behavioural and physiological responses to threat may be distinct from that underpinning the (conscious) emotional experience itself. We empirically tested this notion within a novel, applied context of social and economic importance: fear of falling in older adults. Older adults stood on the edge of a raised platform and were stratified based on whether they reported fear in response to this postural threat. Irrespective of whether participants reported fear, we observed behaviours indicative of postural ‘stiffening’ during the threat condition. Self-reports indicated that participants cognitively monitored these changes in balance, and fear of falling was experienced in those who interpreted these behaviours to imply that harm was likely to occur. Fearful participants exhibited additional changes in balance (increased movement complexity and altered utilisation of sensory feedback) – behaviours likely influenced by attempts to consciously control balance. Taken together, these findings provide novel insight into the systems that regulate behavioural and emotional responses to postural threats. The novel conceptual framework developed from these findings helps identify specific mechanisms that might be targeted for clinical intervention.Economic and Social Research Council SWDTP Postdoctoral Fellowship (Grant Number: ES/V010131/1)

    Comparing the effects of conscious monitoring and conscious control on motor performance

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    We compared the effects of conscious monitoring and control on motor performance. Participants were instructed to adopt an internal or external focus of attention in different blocks of a darts task. For one group, the internal as well as external focus instructions emphasized monitoring. For another group, the instructions emphasized control in the two focus conditions. Furthermore, participants’ propensity for monitoring and control was gauged via two factors of the Movement Specific Reinvestment Scale (MSRS) (Masters, Eves, & Maxwell, 2005). These factors were Movement Self-Consciousness (MS-C) and Conscious Motor Processing (CMP), which measure propensity for conscious monitoring and control, respectively. Performance differences between the internal and external focus blocks were expressed as mean radial error (MRE). Results revealed a 3-way interaction between CMP, instruction type (monitoring versus control) and an order effect. Only in the conscious control-group, but not the conscious monitoring-group was there a 2-way interaction between CMP and order. In the conscious control-group, participants with high CMP scores showed worse performance in whichever focus block (internal or external) was presented last. There were no significant effects in the monitoring-group or of MS-C. These findings indicate that conscious control has a stronger effect on motor performance than conscious monitoring

    Mining for genotype-phenotype relations in Saccharomyces using partial least squares

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    <p>Abstract</p> <p>Background</p> <p>Multivariate approaches are important due to their versatility and applications in many fields as it provides decisive advantages over univariate analysis in many ways. Genome wide association studies are rapidly emerging, but approaches in hand pay less attention to multivariate relation between genotype and phenotype. We introduce a methodology based on a BLAST approach for extracting information from genomic sequences and Soft- Thresholding Partial Least Squares (ST-PLS) for mapping genotype-phenotype relations.</p> <p>Results</p> <p>Applying this methodology to an extensive data set for the model yeast <it>Saccharomyces cerevisiae</it>, we found that the relationship between genotype-phenotype involves surprisingly few genes in the sense that an overwhelmingly large fraction of the phenotypic variation can be explained by variation in less than 1% of the full gene reference set containing 5791 genes. These phenotype influencing genes were evolving 20% faster than non-influential genes and were unevenly distributed over cellular functions, with strong enrichments in functions such as cellular respiration and transposition. These genes were also enriched with known paralogs, stop codon variations and copy number variations, suggesting that such molecular adjustments have had a disproportionate influence on <it>Saccharomyces </it>yeasts recent adaptation to environmental changes in its ecological niche.</p> <p>Conclusions</p> <p>BLAST and PLS based multivariate approach derived results that adhere to the known yeast phylogeny and gene ontology and thus verify that the methodology extracts a set of fast evolving genes that capture the phylogeny of the yeast strains. The approach is worth pursuing, and future investigations should be made to improve the computations of genotype signals as well as variable selection procedure within the PLS framework.</p

    The placebo effect in the motor domain is differently modulated by the external and internal focus of attention

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    Among the cognitive strategies that can facilitate motor performance in sport and physical practice, a prominent role is played by the direction of the focus of attention and the placebo effect. Consistent evidence converges in indicating that these two cognitive functions can influence the motor outcome, although no study up-to-now tried to study them together in the motor domain. In this explorative study, we combine for the first time these approaches, by applying a placebo procedure to increase force and by manipulating the focus of attention with explicit verbal instructions. Sixty healthy volunteers were asked to perform abduction movements with the index finger as strongly as possible against a piston and attention could be directed either toward the movements of the finger (internal focus, IF) or toward the movements of the piston (external focus, EF). Participants were randomized in 4 groups: two groups underwent a placebo procedure (Placebo-IF and Placebo-EF), in which an inert treatment was applied on the finger with verbal information on its positive effects on force; two groups underwent a control procedure (Control-IF and Control-EF), in which the same treatment was applied with overt information about its inefficacy. The placebo groups were conditioned about the effects of the treatment with a surreptitious amplification of a visual feedback signalling the level of force. During the whole procedure, we recorded actual force, subjective variables and electromyography from the hand muscles. The Placebo-IF group had higher force levels after the procedure than before, whereas the Placebo-EF group had a decrease of force. Electromyography showed that the Placebo-IF group increased the muscle units recruitment without changing the firing rate. These findings show for the first time that the placebo effect in motor performance can be influenced by the subject\u2019s attentional focus, being enhanced with the internal focus of attention

    Stay focused! The effects of internal and external focus of attention on movement automaticity in patients with stroke

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    © 2015 Kal et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Dual-task performance is often impaired after stroke. This may be resolved by enhancing patients' automaticity of movement. This study sets out to test the constrained action hypothesis, which holds that automaticity of movement is enhanced by triggering an external focus (on movement effects), rather than an internal focus (on movement execution). Thirty-nine individuals with chronic, unilateral stroke performed a one-leg-stepping task with both legs in single- and dual-task conditions. Attentional focus was manipulated with instructions. Motor performance (movement speed), movement automaticity (fluency of movement), and dual-task performance (dual-task costs) were assessed. The effects of focus on movement speed, single- and dual-task movement fluency, and dual-task costs were analysed with generalized estimating equations. Results showed that, overall, singletask performance was unaffected by focus (p =.341). Regarding movement fluency, no main effects of focus were found in single- or dual-task conditions (p's ≥.13). However, focus by leg interactions suggested that an external focus reduced movement fluency of the paretic leg compared to an internal focus (single-task conditions: p =.068; dual-task conditions: p =.084). An external focus also tended to result in inferior dual-task performance (β = -2.38, p =.065). Finally, a near-significant interaction (β = 2.36, p =.055) suggested that dual-task performance was more constrained by patients' attentional capacity in external focus conditions. We conclude that, compared to an internal focus, an external focus did not result in more automated movements in chronic stroke patients. Contrary to expectations, trends were found for enhanced automaticity with an internal focus. These findings might be due to patients' strong preference to use an internal focus in daily life. Future work needs to establish the more permanent effects of learning with different attentional foci on re-automating motor control after stroke
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