Search

The focus of attention literature has shown robust findings for the benefits of providing statements that focus on the movement effect or outcome (external focus of attention [EFOA]) as opposed to focusing on the movement kinematics (internal focus of attention). Observational studies, however, have revealed that physiotherapists use fewer EFOA statements than internal focus of attention statements in their practice. Most evidence in this regard has been from non-Canadian physiotherapists working in stroke rehabilitation; consequently, we sought to examine whether Canadian physiotherapists working with various rehabilitation populations also use EFOA statements to a lesser extent than internal focus of attention statements. The "Therapists' Perceptions of Motor Learning Principles Questionnaire (TPMLPQ)" was thus designed and data from 121 Canadian physiotherapists showed low relative frequencies of EFOA use (31.3% ± 14%) averaged across six hypothetical scenarios. A higher EFOA was reported, however, for two of the six scenarios: a functional reaching scenario (55.5% ± 37.0%) and pelvic floor task (65.6% ± 32.9%). This data suggest that the findings of EFOA benefits have not been widely translated into Canadian physiotherapy settings; furthermore, the findings of the scenario-dependency warrant future investigation into factors, such as task characteristics, that may influence physiotherapists' FOA use.

Although researchers have consistently demonstrated the potential benefit of an external focus of attention for rehabilitation, research has shown that this finding has yet to be translated into Canadian physiotherapy. Further, specific barriers to external focus use have been reported by Canadian physiotherapists, and as a solution toward increasing physiotherapists' use of external focus, these same physiotherapists recommended the development of an educational workshop on focus of attention. Considering this, described herein is the process of developing such a workshop, which involved (a) gathering input from physiotherapists concerning content and format via one-on-one interviews and (b) engaging in discussion about content with focus of attention researchers. Analysis of the interview data featured key content for the workshop, the types of activities to include, and a recommended sequencing for the activities: specifically, sharing didactic information on focus of attention research, then providing instruction and demonstration of external focus use, and finally, finishing with opportunities for generating and delivering external focus statements. This input, along with that of the researchers, led to the development of a two-component focus of attention workshop, which includes an asynchronous component, featuring seven self-directed learning modules and a synchronous component, which consists of a virtual group session. [For Part 2, see EJ1398983.]

Although researchers have highlighted the benefits of adopting an external focus of attention for rehabilitation, studies have consistently revealed low external focus use by physiotherapists. Consequently, the purpose of this research was to explore factors influencing physiotherapists' focus of attention use and to gain insight into the barriers, and potential solutions, related to effective external focus use. Eight physiotherapists, working with musculoskeletal rehabilitation clients, first completed the Therapists' Perceptions of Motor Learning Principles Questionnaire and then participated in virtual one-on-one interviews. The interviews followed a semistructured interview guide and were analyzed using a total quality framework approach to qualitative content analysis. Data showed that physiotherapists' focus of attention use was influenced by physiotherapist, client, and task characteristics/experiences, as well as focus of attention statement provision strategies. Furthermore, the main barriers discussed related to educational experiences, reinforcement of internal focus of attention statement use and aspects related to research. Solutions presented to these barriers included the incorporation of focus of attention content into both the Canadian physiotherapy curriculum and continued education. Overall, these results advance our knowledge of factors underlying physiotherapists' focus of attention use and barriers that must be overcome to successfully translate the focus of attention research into physiotherapy. [For Part 1, see EJ1387168.]

In previous research, Canadian physiotherapists identified barriers to effective external focus promotion and recommended the delivery of a focus of attention workshop as a solution. Accordingly, the current research entailed the virtual delivery of such a workshop, consisting of asynchronous Website modules followed by a synchronous group session, to 15 Canadian physiotherapists working mainly with musculoskeletal rehabilitation clients. Assessment of the workshop outcomes was guided by constructs of social cognitive and adult learning theory, and organized based on the four levels of the Kirkpatrick model (KP1-Reaction, KP2-Learning, KP3-Behavior, and KP4-Results). Specifically, participants received links to questionnaire packages at three time points: 1-week preworkshop, immediately postworkshop, and 1-week postworkshop. Results showed that participants (a) reported high satisfaction, engagement, and perceived relevance of the workshop (KP1); (b) experienced significant improvements to their knowledge, skills, attitudes, and self-efficacy from pre- to immediately postworkshop (KP2); and (c) self-reported increases to their external focus promotion in the week following the workshop (modified KP3), and perceived improvements to their clients' outcomes as a result of this external focus encouragement (modified KP4). Taken together, these results serve as a chain of evidence supporting the usefulness of the workshop in translating focus of attention findings into Canadian physiotherapy. [ABSTRACT FROM AUTHOR]

This study aimed to explore the preferences, self-efficacy to overcome barriers and motives for physical activity of individuals with severe obesity (body mass index ≥35 kg/m2). 44 adults with severe obesity (50.5 ± 13.3 years, 80% female) consented to participate in this study. Accelerometers, the 6-minute walking test, and questionnaires were used to collect data on participants' sociodemographic and medical characteristics, physical fitness, physical activity behaviour, preferences for physical activity, self-efficacy to overcome physical activity barriers and motives for physical activity. A preference for walking (89%) and engaging in supervised physical activity (61%) at moderate intensity (46%) was reported. Most participants (71%) preferred engaging in physical activity outdoors for a duration of 30 to 60 min (84%), either in the morning (64%) or in the evening (48%). Participants had the lowest self-efficacy to overcome physical activity barriers when they had poor health and pain. The two most frequently reported physical activity motives were: preventing health problems and having better health. A preference-based program focusing on health motives and addressing health and pain issues may help to promote physical activity behaviour among adults with severe obesity. Nevertheless, experimental studies are needed to determine if such strategies effectively increase physical activity behaviour in this population. Physical activity preferences (i.e., walking, biking and swimming performed at a moderate intensity and outdoors for a duration of 30 minutes to 1 hour with supervision) can be used to enhance motivation in people with severe obesity. Addressing the main barriers of regular physical activity (e.g., poor health, pain, depression) could ensure better adherence to physical activity in people with severe obesity. Using motives of health improvement and health problems prevention could lead to increased physical activity in people with severe obesity. [ABSTRACT FROM AUTHOR]

Background: Cancer is a chronic condition associated with a substantial symptom burden, which can impair recovery after treatment. Investigating interventions with potential to improve self-reported disease and/or treatment effects-known as patient-reported outcomes (PROs)-is paramount to inform cancer care. The objective of this study was to evaluate the effects of a yoga therapy (YT) intervention on key PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life [QoL]) among adults after treatment for cancer., Methods: Data from 20 adults ( M age  = 55.74 years, 85% female; M time since diagnosis  = 2.83 years) who had completed treatment for cancer were analyzed for this study. In this single-subject exploratory experimental study, the YT intervention comprised a 1:1 YT session (ie, 1 participant with 1 yoga therapist) followed by 6 weekly small (ie, 2-3 participants) group YT sessions. Group sessions were facilitated by the same yoga therapist who delivered participants' 1:1 session to ensure an in-depth personalized approach. PROs were assessed before (ie, pre-intervention) and after the 1:1 YT session (ie, during the intervention), as well as after the last group YT session (ie, post-intervention). Hierarchical linear modeling was used to analyze the data., Results: Participants showed improvements in cancer-related fatigue, state anxiety, trait anxiety, perceived cognitive impairments, impacts of perceived cognitive impairments on QoL, and 1 dimension of QoL (ie, functional wellbeing) over time. Notably, cancer-related fatigue and state anxiety increased immediately after the 1:1 session, but showed greater improvements over time afterward (ie, during the intervention phase). No changes were observed for the remaining PROs., Conclusion: Although results require confirmation in future trials, this study highlights the importance of continuing to investigate YT as an intervention to enhance important PROs (ie, cancer-related fatigue and state anxiety) after treatment for cancer. More research is needed to identify additional beneficial effects and factors that influence participants' responses to 1:1 and group YT (ie, moderators and mediators)., Registration Number: ISRCTN64763228., Date of Registration: December 12, 2021. This trial was registered retrospectively., Url of Trial Registry Record: https://www.isrctn.com/ISRCTN64763228., Published Protocol: Brunet, J., Wurz, A., Hussien, J., Pitman, A., Conte, E., Ennis, J. K., . . . & Seely, D. (2022). Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integrative Cancer Therapies , 21 , 15347354221075576., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.