Research article

A randomised controlled trial investigating motor skill training as a function of attentional focus in old age

Eling D de Bruin^1,2 , Jaap Swanenburg² , Elsbeth Betschon¹ and Kurt Murer¹

¹  D-Biology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland

²  Department of Rheumatology and Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland

author email corresponding author email

BMC Geriatrics 2009, 9:15doi:10.1186/1471-2318-9-15

Published:	8 May 2009

Abstract

Background

Motor learning research has had little impact on clinical applications and rarely extended to research about how older adults learn motor skills. There is consistent evidence that motor skill performance and learning can be enhanced by giving learners instructions that direct their attention. The aim of this study was to test whether elderly individuals that receive an external focus instruction during training of dynamic balance skills would learn in a different manner compared to individuals that received an internal focus instruction.

Methods

This randomised trial included 26 older persons (81 ± 6 years) that were training functional balance twice a week for the duration of 5 weeks. Learning outcomes were recorded after every training session. Weight shifting score and dynamic balance parameters (Biodex Balance System), components of the Extended Timed-Get-Up-and-Go test, five chair rises, and falls efficacy (FES-I) was assessed at baseline and post-intervention.

Results

Participation for training sessions was 94%. No differences between groups were found following 5 weeks of training for weight shifting score, dynamic balance index and dynamic balance time (p < 0.95, p = 0.16, p < 0.50), implying no learning differences between training groups. Extended Timed-Get-Up-and-Go components Sit-to-stand, p = .036; Gait initiation, p = .039; Slow down, stop, turnaround, and sit down, p = 0.011 and the Fes-I (p = 0.014) showed improvements for the total group, indicating that function improved compared to baseline.

Conclusion

A 5-week balance training improved weight shifting scores and dynamic balance parameters as well as functional abilities. The observed improvements were independent from the type of attentional focus instructions. The findings provide support for the proposition of different motor learning principles in older adults compared to younger adults.

Trial Registration

ISRCTN44627088