Attentional Focus and Motor Learning in Clinical Settings and in Older Age: A Review

Abstract

During the past two decades, research has shown that an external focus (EF) of attention is superior to an internal focus (IF) of attention when performing a variety of motor skills. However, most of the studies on the use of EF and IF instructions for motor skill acquisition were conducted on young and healthy adults. The purpose of the current article was fourfold: (a) to review the current research on attentional focus in clinical populations and in older age, (b) to provide evidence-based knowledge about attentional focus instructions and their possible advantages in clinical settings, (c) to discuss methodological concerns associated with the reviewed studies, and (d) to propose practical implications for those who work with clinical populations and older individuals. We found that in 14 out of the 18 reviewed studies, EF instructions led to results that were superior to those of IF instructions. For example, in stroke patients, EF instructions can lead to faster, smoother, and more forceful reaching movements compared with IF instructions. However, a number of methodological concerns should be taken into account, among them the lack of a control group and the absence of studies using electromyography.