Gait Stability in Older Adults during Level-ground Walking: The Attentional Focus Approach

Abstract

Objectives: The objective is to investigate the effect of attentional focus instructions on gait stability during level-ground walking among older adults. Method: We recruited 140 community-dwelling older adults (mean age = 70.3 years, SD = 4.7 years) from elderly community centres in Hong Kong. The experiment included assessments on participant’s characteristics and walking trials. During walking trials, each participant was invited to walk at a self-selected pace along a 6-metre walkway. Either internal focus instructions (Internal condition), external focus instructions (External condition) or no instruction (Control condition) were given in a randomized order for 3 trials per condition, giving a total of 9 walking trials. Spatial and temporal gait parameters were measured. Results: Results showed significantly higher body sway and variability of swing and stance time under Internal condition relative to External and Control conditions. Moreover, reduced velocity and shorter steps were demonstrated under Internal condition relative to External and Control conditions. Discussion: External focus instructions did not improve gait stability in older adults when compared to Control condition. Internal focus instructions appear to compromise gait stability. Future research should investigate if walking instructions that refer to body movements explicitly compromise gait rehabilitation for older adults in clinical settings.