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This study will be a pilot randomized controlled trial, to investigate the effectiveness of an external focus training on visuomotor performance while comparing with an active control group.
All eligible participants will be randomly divided into two groups: external focus gait training group (EXT) and active control group (CON). All participants will complete two assessment sessions: at baseline (T0) and immediately following the completion of all training sessions (T1). A total of twelve training sessions (about 45 minutes per session), held twice a week for six weeks, would be provided to participants in both training groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EXT | Experimental | External focus manipulation |
|
| CON | Active Comparator | Traditional manipulation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Attentional focus | Behavioral | Every training session will include the following activities for both groups: a 5-minute warm-up; a 30-minute walking training; and a 5-minute cool-down. The walking training will be conducted within a level-ground walking field. Participants will be instructed to look at and step on specific markers/labels that will be attached along the walking paths. |
| Measure | Description | Time Frame |
|---|---|---|
| Gait stability - variability of stride time | measured by a 3-D motion capture system; stride time is defined as the interval between two consecutive heel strikes of the same foot; the variability measure is represented by the coefficients of variation (CV) [(standard deviation/mean) × 100] | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Gait stability - variability of stride length | measured by a 3-D motion capture system; stride length is defined as anterior-posterior (A-P) distance between two consecutive heel strike positions of the same foot; the variability measure is represented by the coefficients of variation (CV) [(standard deviation/mean) × 100] | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Gait stability - variability of step width | measured by a 3-D motion capture system; step width is defined as medial-lateral (M-L) distance between two consecutive heel strike positions of the opposite feet; the variability measure is represented by the coefficients of variation (CV) [(standard deviation/mean) × 100] | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Visual search behaviours - location of fixation | measured by a wireless eye tracker; recorded the location that the gaze is fixated on | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Visual search behaviours - the number of fixation | measured by a wireless eye tracker; recorded the number of times the gaze is fixated on each area of interest | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Measure | Description | Time Frame |
|---|---|---|
| Functional balance and gait | measured by the Tinetti Balance Assessment Tool; min: 0; max: 28; higher scores reflect better functional balance and gait | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Falls efficacy |
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Inclusion Criteria:
Exclusion Criteria:
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| Control | Behavioral | Every training session will include the following activities for both groups: a 5-minute warm-up; a 30-minute walking training; and a 5-minute cool-down. The walking training will be conducted within a level-ground walking field. No markers/labels will be attached and no relevant instructions will be provided apart from the general instruction. |
|
| Visual search behaviours - fixation duration | measured by a wireless eye tracker; recorded the duration that the gaze is fixated on each area of interest | baseline (pre-intervention), immediately after intervention (post-intervention) |
measured by the Chinese version of the Falls Efficacy Scale International; min: 16; max: 64; higher scores reflect greater concern about falling
| baseline (pre-intervention), immediately after intervention (post-intervention) |
| Conscious movement processing | measured by the Chinese version of the Movement Specific Reinvestment Scale; min: 10, max: 60; higher scores reflect higher propensity for conscious movement processing | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Functional balance | measured by the Berg Balance Scale; min: 0; max: 56; higher scores reflect better functional balance | baseline (pre-intervention), immediately after intervention (post-intervention) |
| Functional mobility | measured by the Timed 'Up & Go' Test (in seconds); a longer time to complete reflects poorer functional mobility | baseline (pre-intervention), immediately after intervention (post-intervention) |