The Effect of External Attentional Focus and Self-Controlled Feedback on Motor Learning in Older Adults

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Abstract Introduction. External focus instruction and self-controlled feedback have beneficial effects on motor learning. The purpose of the present study was to investigate the benefits of combined effects of external focus instruction and self-controlled feedback on balance performance in older adults. Material and Methods. Forty older adults (mean age: 63.21 ± 3.6 years; all female) were selected and randomly divided into 4 groups: self-controlled feedback, external attention, external attention/self-controlled feedback and control group. The task of standing on the platform of the stabilometer device and trying to keep the platform horizontally as much as possible was performed in each 30-sec. trial. The participants of self-controlled group received feedback on the timing of balance after the trials. In the external focus of attention, participants noticed the signs that were located horizontally ahead of their feet. The test was conducted in two sessions. In the acquisition phase, 10 trials of 30 seconds were performed and the retention test was completed 24 hours later as 5 trials of 30 seconds. Results. The results of mixed ANOVA on time data as an indicator of balance in the acquisition phase showed that the mixed group of external focus of attention and self-controlled feedback had better performance than the other groups (p = 0.004). In the retention test, the results of mixed ANOVA showed that the participants in the combined group of external focus and self-controlled feedback had better performance than the other groups (p = 0.006). The external focus of attention and self-controlled feedback performed similarly, and both were superior to the control group (p < 0.05). Conclusions. The results of this study, supporting the OPTIMAL theory of motor learning in the elderly, showed that the combination of two factors of external focus and self-controlled feedback has a double advantage over the presence of each of the factors. Therefore, it is suggested that the combinations of external focus instructions and self-controlled feedback should be used to improve performance and motor learning in the classes of practical and clinical rehabilitation fields.