Focus of Attention Types on Muscular Endurance in Multiple Sclerosis Patients with Different Levels of Fatigue

Various studies have shown the advantages of an external focus of attention on multiple sclerosis patientschr('39') performance, and they have used the constrained-action hypothesis to explain this effect. Most of these studies have investigated the effect of attention types on walking variables such as static and dynamic balance in these patients, regardless of their fatigue level. The effect of the focus of attention types on fatiguing tasks has been ignored in these patients. While there is certainly evidence that with increased intensity and subsequently increasing fatigue, internal cues Caused by pain and fatigue become harder to block out of attention and mental processing. Fatigue is one of the main characteristics of patients with multiple sclerosis. This study aimed to focus on attention types on muscular endurance in multiple sclerosis patients with different levels of fatigue.

The present study was semi-experimental, including an intragroup design. Statistical sample included 45 men with MS Who purposively selected Among referrals to MS Society of Esfahan city; At first, Eligible participants completed the standard fatigue questionnaire then, from each of the groups with a low level of fatigue (scores between 1 to 2. 8), the average fatigue level (scores between 2.8 to 1. 5) and the high level of fatigue (scores above 5. 1), 15 People (45 people in total) were selected. After being given informed consent, the nature of the task was described to the subjects. Subjects were told that they would do a “wall-sit, and You will stand with your back flat against the wall, walk your feet out until your knees and ankles are both at a 90° angle, and then hold this position for as long as you can. All subjects completed a short trial (lasting 10 s) prior to the start of the main experimental trials. Subjects performed a muscle endurance task under the two external and internal Focus of attention. For the external focus of attention, subjects were reminded to visually focus on the fixation point on the opposite wall and for the internal focus of attention, subjects were reminded to visually focus on the fixation marker on the knee joint. The wall-sit is a common exercise (muscle endurance task) in People across a range of age and skill levels and creates a considerable amount of fatigue in the leg muscles very quickly. To measure performance in the wall-sit task, we measured the time that subjects could maintain the wall-sit position. The paired-sample t-test was used to compare each group in two conditions (the external and internal focus of attention). Analyses were based on Shapiro–Wilkchr('39')s of normality and homogeneity of variance tests for all analyses, the level of significance was set at p<0.05.

The results of paired- sample t test showed that muscular endurance of multiple sclerosis patients with low and moderate intensity fatigue in external focus of attention Condition was significantly more than internal focus of attention Condition (p<0.05) but, in patients with High intensity fatigue, there was no significant difference in the different attentional conditions.

It seems that high fatigue multiple sclerosis patients prevent the external focus of attention. So when the focus of attention instructions is given to Multiple Sclerosis Patients, You Should pay attention to the Level of their fatigue. In addition, the results of this research in Multiple Sclerosis Patients with the low and average fatigue level has important implications because it suggests that the primary benefit of focusing externally in this task (wall-sit) was using distraction to block out internal sensations of fatigue which are made more salient by focusing internally.