presented by Martha Acosta & Karen L. McCulloch
This course is part of a series on cognitive impairments seen in neurologic conditions. The purpose of this course is to review attention-related issues relevant to physical therapists and other allied health staff. In particular, this course covers how to screen and identify possible attention problems, as well as how to perform testing that integrates attention into functional mobility skills.
Dr. Acosta received her Bachelors degree in Physical Therapy from the University of Texas Medical Branch in Galveston, Texas after receiving a Bachelors degree in Pre-Medicine from the University of Southwestern Louisiana. After working several years as a clinician, she went on to pursue a Masters degree in Healthcare Administration from Southwest Texas State University. She was awarded a PhD from the University of Texas Medical Branch in Preventive Medicine and Community Health (Rehabilitation Sciences). Dr. Acosta has worked in a variety of settings including acute care, rehabilitation, out-patient, long-term care, skilled nursing facilities, psychiatric hospital, and home health. With approximately 35 years of clinical practice, she brings an abundance of expertise and clinical application to the academic setting to enhance student learning of clinical concepts. She has taught previously at the University of Texas at El Paso where the focus of her teaching responsibilities included management of the adult patient with neurological impairments. She also taught management of health care systems for Physical Therapists as well as geriatric elective courses and hippotherapy. Dr. Acosta also has been awarded clinical specialist certification by the American Physical Therapy Association (APTA) as a Geriatric Clinical Specialist (GCS). She also is an item writer for the board certification exam and is a member of the APTA Specialization Academy of Content Experts. Her current teaching responsibilities include topics of clinical foundation skills for first-year physical therapy students and aging across the lifespan for third-year physical therapy students.
Karen L. McCulloch, PhD, PT, MS, NCS, is a Professor in Physical Therapy in the Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine at University of North Carolina – Chapel Hill, where she has taught entry-level and advanced-level students in neurorehabilitation since 1993. She has served in multiple roles within the Academy of Neurologic Physical Therapy, including the inaugural Director of Education, and has been honored with the Service to the Section Award and the APTA Lucy Blair Service Award. Karen has cared about individuals with traumatic brain injury since beginning as a PT in clinical practice, extending from moderate to severe brain injury to a recent focus on concussion. Her research has focused on developing outcome measures and interventions to improve active movement, balance, and functional mobility, with the aim to improve quality of life. She developed the Arm Motor Ability Test (for upper limb recovery following stroke) and the Walking and Remembering Test (for dual-task performance in older adults and individuals with acquired brain injury). She served as an ORISE Fellow with the Army Office of the Surgeon General, addressing TBI issues that affect individuals in military service. Her current research efforts are focused on wounded warriors with mild traumatic brain injury as part of a team that developed the Assessment of Military Multitask Performance, a test battery of challenging dual- and multi-task activities. She is currently leading a group writing a clinical practice guideline for physical therapy management of concussion, and is involved in intervention studies that address treatment for sports and military concussion. Funding support for her research has come from the Foundation for Physical Therapy, Centers for Disease Control and Prevention, National Institutes of Health, National Football League, and Department of Defense.
This chapter answers the question, "what is attention?" The prerequisites of attention are covered, including: alert, orient, and select. Components of the brain involved in attention will also be discussed.
In this chapter, the types of attention will be covered: sustained, focused, alternating, and divided. A case example will be discussed to show how modifications to an environment can reduce distractions and improve motor skills.
The link between dual-task performance impairments and fall risk/safety concerns will be covered in this chapter. Foundational literature in older adults will be discussed, as well as additional literature in patients with stroke, PD, and TBI.