Durham, Katherine Frances (2011)
Ph.D. thesis, University of Birmingham.
Feedback which induces an external focus of attention, about movement effects, has been found to promote motor performance in healthy subjects. It is unknown whether this effect transfers to retraining reach-to-grasp after stroke.
This thesis first explored the attentional focus of feedback used by therapists and adopted a mixed methods paradigm. Where feedback was used it predominantly induced an internal focus of attention, about body movements. The main experimental study compared feedback which induced either an internal or external focus of attention during the motor performance of reach to grasp after stroke. A counterbalanced design was used and reaching movements were recorded using motion analysis. Support was found for adopting an external focus of attention compared with an internal focus of attention, although an interaction between feedback type and order was also found. Finally, the influence of the level of arm and memory impairment on the feedback type was explored. Neither the level of arm or memory impairment was found to influence feedback type.
This study highlights the complexities of providing feedback after stroke and suggests that adopting an external focus of attention may be beneficial to improving motor performance after stroke.
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