Recruiting

Focus of Attention

Sponsor:

Western Carolina University

Code:

NCT07460804

Conditions

Stroke

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Focus of Attention

Study Details

Brief summary:

The purpose of this study is to fill some gaps in the literature by examining the effects of focus of attention on motor learning and motor performance of sit to stand in individuals post chronic stroke. This study will investigate whether an internal or external focus of attention can lead to improved use of the affected lower extremity during the sit to stand transition, while maintaining an upright trunk position. More specifically, the study has two purposes. The first is to determine whether an external or internal focus of attention would lead to better motor learning of sit to stand. This is measured by retention testing and transfer of the task to changes in affected lower extremity weight bearing during gait. The second purpose of this study is to investigate whether an internal or external focus of attention affects the performance of sit to stands during training.

Conditions

Stroke

Study ID

NCT07460804

Start date

Mar 26, 2025

Status verified date

Jul, 2025

Completion date

Dec 31, 2027

Anticipated

Primary completion date

May 16, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Stroke >6 months
  • Mild to moderate stroke (NIHSS scores 0-15)

Exclusion Criteria:

  • Unable to perform sit to stand from a standard height 20" chair without physical assistance
  • Unable to walk 20 feet with or without an assistive device at a contact guard to independent level
  • Individuals with severe cognitive impairment (<10/30 on the Montreal Cognitive assessment)
  • Contraversive pushing (> 1 on the Scale for Contraversive Pushing)
  • Neglect as evidenced by <44/54 on the star cancellation test
  • Any orthopedic conditions that impact their ability to transition from sit to stand will be excluded from the study.
  • Any other neurologic conditions that impact their ability to transition from sit to stand will be excluded from the study.
  • Minors, prisoners, pregnant women will also be excluded.
  • Non English speaking individuals due to lack of interpretation resources.

Study Design

Enrollment

20 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

active comparator: Internal focus of attention group

Participants were given instructions that make them think about their body's movements.

Prior to training, a demonstration of the task was provided to the participants with emphasis to weight shift towards the affected side. For the internal focus condition, participants were told, "as you stand up and as you sit down bring your right/left (R/L) shoulder and R/L hip as far to the R/L as possible." Participants were asked to perform one repetition with the question "can you show me?" The demonstration was only provided before the first set, but the same verbal instructions were given prior to the start of each successive set during training. During training, individuals performed four sets of 10 sit to stand repetitions, yielding a total of 40 repetitions.

experimental: External focus of attention group

Participants were given instructions that make them think about an outside target/outcome.

Prior to training, a demonstration of the task was provided to the participants with emphasis to weight shift towards the affected side. For the internal focus condition, participants were told, "as you stand up and as you sit down try to bring the targets together like this." Participants were asked to perform one repetition with the question "can you show me?" The demonstration was only provided before the first set, but the same verbal instructions were given prior to the start of each successive set during training. During training, individuals performed four sets of 10 sit to stand repetitions, yielding a total of 40 repetitions.

Interventions

Focus of Attention

Focus of attention instruction and feedback. Focus of attention refers to what people are thinking about during motor tasks. An external focus refers to thinking about an outside outcome or target. An internal focus of attention refers to thinking about how someone is moving their body.

During training, participants performed four sets of sit to stand transitions with the mat at progressively lower seat heights to increasingly challenge the participants, with instruction and feedback consistent with their condition allocation. The four sets occurred in the following sequences: 130% of the initial mat height determined at baseline assessment 120%, 110%, and 100%. Each set ended after the tenth repetition or when the participant reported an RPE rating of >16/20. During training, one verbal correction was given during each set after the second, fourth, and seventh repetition.

Primary outcome measure

  • Center of pressure under their feet [ Time Frame: Baseline ]
  • Center of pressure under their feet [ Time Frame: Acquisition (one 1 hour training) ]
  • Center of pressure under their feet [ Time Frame: Immediate Post (5 minutes after acquisition training) ]
  • Center of pressure under their feet [ Time Frame: Long term (one hour after acquisition/training) ]
  • Trunk alignment [ Time Frame: Baseline ]
  • Trunk alignment [ Time Frame: Acquisition (one 1 hour training) ]
  • Trunk alignment [ Time Frame: Immediate Post (5 minutes after acquisition training) ]
  • Trunk alignment [ Time Frame: Long term (one hour after training) ]
  • Post Manipulation Questionnaire [ Time Frame: Long term (after all measures completed 1 hour after training) ]

Central Contacts and Locations

Central contacts

Ashley Watamura, PT, DPT, PhD

717-682-9710awhyatt@email.wcu.edu

Locations

Western Carolina University

Recruiting

Cullowhee, North Carolina, United States, 28723

Contacts

Ashley R Watamura, DPT, PhD

7176829710awhyatt@email.wcu.edu

Dave Hudson, PhD

8282272191dhudson@email.wcu.edu

Principal Investigator:

Ashley R Watamura, DPT, PhD

More Information

Sponsor

Western Carolina University

Last update posted

Mar 10, 2026

Last verified

Jul, 2025

Keywords

  • Motor learning
  • Focus of attention
  • Sit to stand

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Western Carolina University on 2026-03-10.