Superiority of external attentional focus for motor performance and learning: Systematic reviews and meta-analyses.

Abstract

Considerable literature on the role of attentional focus in motor performance and learning has accumulated for over two decades. We report the results of comprehensive meta-analyses that address the impact of an external focus (EF, on intended movement effects) versus internal focus (IF, on movements of body parts) of attention on the performance and learning of motor skills. Values of effect sizes (ES) from 73 studies with 1,824 participants and 40 studies with 1,274 participants were used for examining the effects of EF versus IF on behavioral outcomes of motor performance and learning (separately for retention and transfer phases) respectively. The EF condition was more effective than the IF condition for performance, Hedges’ g value = 0.264 (95% CI [0.217, 0.310]), retention learning, Hedges’ g value = 0.583 (95% CI [0.425, 0.741]), and transfer learning, Hedges’ g value = 0.584 (95% CI [0.325, 0.842]). Multivariable metaregression analyses on behavioral measures further indicated that neither age group, health status, or skill level, nor their two-way interactions, moderated the ES differences between EF and IF in performance, retention, and transfer models (all p > .100). A secondary analysis on 12 studies with 216 participants that examined the effects of EF versus IF on electromyographic outcomes of motor performance also indicated that EF was associated with more efficient neuromuscular processing, Hedges’ g value = 0.833 (95% CI [0.453, 1.213]). From nine studies with 272 participants, performance measured by behavioral outcomes was found to be more effective when a more distal, rather than proximal, EF was used, Hedges’ g value = 0.224 (95% CI [0.019, 0.429]). Overall, the meta-analytic results are consistent with prior narrative reviews and indicate that an external focus is superior to an internal focus whether considering tests of motor performance or learning, and regardless of age, health condition, and level of skill expertise.

A Wearable Mixed Reality Platform to Augment Overground Walking: A Feasibility Study

“…In this study, our participants appeared to successfully modulate their gait speed during a single-day session when provided concurrent visual feedback and an external focus by the MR-HMD. Our findings align with substantial evidence supporting an external focus to promote motor performance and learning (Wulf, 2013 ; Chua et al, 2021 ). Our results also align with previous research which reports the benefits of extrinsic visual cues on motor learning in healthy individuals (Todorov et al, 1997 ; Sigrist et al, 2013 ; Lewthwaite and Wulf, 2017 ) and persons with physical disability (Aung and Al-Jumaily, 2014 ).…”

Practice—Not Task Difficulty—Mediated the Focus of Attention Effect on a Speed-Accuracy Tradeoff Task

“…The finding of attentional focus differences during retention or transfer, but not during acquisition, has been previously reported for a balance task (Wulf et al, 1998; 2001a, 2001b; Chiviacowsky et al, 2010) and a dart-throwing task (Lohse et al, 2010). It is also noteworthy that a recent meta-analysis (Chua et al, 2021) found larger effects for attentional focus differences in retention than acquisition, and in transfer than retention.…”

Translating Thoughts Into Action: Optimizing Motor Performance and Learning Through Brief Motivational and Attentional Influences

“…What performers concentrate on while preparing for and executing a motor skill matters; what target one intends to hit, rather than how to move the body to achieve it, affects success. A considerable literature examining the role of attentional focus on motor performance and learning has accumulated over the past two decades (Chua et al, in press; Wulf, 2013). This line of research has demonstrated that an external focus of attention, or concentration on the intended effect of the movement (e.g., planned trajectory of a ball, stability of a balance platform, sound to be produced), results in better performance and learning than does an internal focus, or concentration on body movements.…”