ABSTRACT NUMBER: ESOC2026OT33 THE EFFECT OF COMBINED AND SEQUENTIAL ATTENTION FOCUS INSTRUCTIONS ON UPPER EXTREMITY FUNCTIONS IN SUBACUTE STROKE PATIENTS

Abstract Background and aims Attentional focus instructions modulate motor learning after stroke, but the benefits of combining internal and external focus of attention instructions versus sequencing them are unknown. Methods To compare combined and sequential focus of attention instructions against no specific instructions for upper extremity motor recovery in subacute stroke. Results The study was designed as a single-centre, three-arm, parallel-group, assessor-blinded, randomized controlled trial (1:1:1). Adults diagnosed within the first six months after stroke are allocated to: combined focus (CFG), sequential focus (SFG), or control (CG) groups. The primary outcome was the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), and secondary outcomes included the Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Modified Ashworth Scale (MAS), and Montreal Cognitive Assessment (MoCA). Assessments were conducted at baseline and post-intervention (at the end of the 4th week) by an assessor blinded to group allocation. All groups receive a four-week programme of 45-minute sessions, five times per week, within a standard rehabilitation pathway including range-of-motion and functional exercises. The SFG received internal focus instructions followed by external focus instructions, CFG received internal and external focus instructions together, and CG received no specific instructions. Conclusions We hypothesised that the CFG would demonstrate superior improvements in all assessed outcomes, including FMA-UE, ARAT, and WMFT, compared with the SFG and CG. Conflict of interest