External Focus Of Attention Research Articles

Immediate effects of verbal instructions with internal focus of attention and external focus of attention on forward reach movement while standing.

[Purpose] This study aimed to examine the immediate effects of verbal instructions with an internal and external focus of attention on forward reach movement while standing. [Participants and Methods] Thirty-seven healthy young males performed reach movement in three conditions: control, internal focus of attention, and external focus of attention. The measurements recorded were the movement distance of the third metacarpal bone (reach distance), the distance of the center of pressure, and the movement angles between the acromion and malleolus lateralis and between the acromion and trochanter major. [Results] Compared to the control condition, the internal focus of attention condition had a lower reach distance, angles between the acromion and malleolus lateralis and between the acromion and trochanter major, and center of pressure distance. In contrast, compared to the control condition, the external focus of attention condition showed higher reach distance and angles between the acromion and malleolus lateralis and between the acromion and trochanter major. The change rate of reach distance in the internal and external focus of attention conditions correlated significantly with the change rates of the angles between the acromion and malleolus lateralis and between the acromion and trochanter major. [Conclusion] Verbal instructions with attentional focus resulted in the simultaneous adjustment of the positional relationship between trunk and hip and immediately affected the reach distance. Our findings suggest that verbal instruction with attentional focus is an important factor affecting reach movement.

Practicing Musical Intention: The Effects of External Focus of Attention on Musicians’ Skill Acquisition

Movement science research indicates that an external focus of attention benefits learning as well as performing movement. Despite these findings from the field of sports, research on the effects of external focus in music pedagogy is sparse, especially in naturalistic settings. This in-depth, small-sample study investigated the effect of external focus on musical learning in terms of accuracy, self-efficacy, confidence, motivation, and engagement, as well as the qualitative performance experience. Seven conservatoire (natural trumpet) students practiced challenging, unfamiliar pieces in short practice sessions using their normal practice methods, followed by a trial using the instructions of the Audiation Practice Tool (APT). This tool was developed to enhance auditory and kinaesthetic engagement as well as detailed musical intention through vivid imagination, singing, gesturing, playing, and seeking musical variation. Use of the APT resulted in higher performance accuracy than participants’ usual practice methods, and a non-significant trend for improvement in self-efficacy and confidence compared to practice as usual. Logbook scores were inconclusive on motivation and engagement; however, exit questionnaire answers showed that most participants experienced audiation or external focus as engaging and enjoyable. Although none of the participants initially favored external focus, participants generally intended to continue using elements of the APT. This study suggests that the use of external focus could be more explicit and prominent in teaching and in practicing music.

The Impact of Different Attentional Focus Strategies During Modeling on the Acquisition and Retention of Free Throws in Basketball

Background: In recent years, coaches and athletes have increasingly used observation as a tool for teaching and learning sports skills. Objectives: The aim of this study was to investigate the impact of modeling, using internal and external attentional focus strategies, on the acquisition and retention of free throw shooting in basketball. Methods: Forty-five female beginner basketball players (aged 21.62 ± 3.08 years, with a BMI of 23.48 ± 0.99 kg/m2) voluntarily participated in this study. Based on their pre-test scores using the ABBA method, they were divided into three groups: One group received modeling with an internal attention focus strategy, another group received modeling with an external attention focus strategy, and a control group. A video demonstrating the correct throwing technique was used to teach the attention-focusing strategies, and the groups did not receive any physical training. After watching the video, participants performed their own throwing attempts. Following group allocation, the participants entered the acquisition phase, which consisted of six sessions, with each session including two sets of ten attempts and a 2-minute rest period between sets. One-way analysis of variance was used for both immediate and delayed recall tests, and data analysis was conducted using SPSS 20 software.” Results: The study found a significant difference in free throw performance between the three modeling groups (internal attention focus, external attention focus, and control) during both the acquisition and delayed retention stages (P ≤ 0.05). Additionally, there was a significant difference in basketball free throw performance between the three modeling groups during the recall test (P ≤ 0.05). Conclusions: Overall, the results suggest that observational learning, combined with attentional focus strategies, is an effective method for improving skill acquisition and retention in basketball.

External and internal focus of attention differentially modulate corticospinal excitability in anticipatory postural adjustments

Whether attentional focus modulates the corticospinal excitability of the lower limb muscles in anticipatory postural adjustments (APAs) when performing a ballistic movement of the upper limb remains unclear. The present study used transcranial magnetic stimulation (TMS) to examine the corticospinal excitability of the lower limb muscles along with the kinematic profiles during dart throwing with different attentional foci, external focus (EF) and internal focus (IF). In 13 healthy participants, TMS was applied immediately before electromyographic onset of the tibialis anterior (TA) muscle, and the motor evoked potential (MEP) was recorded in the TA and soleus (SOL) muscles. The performance accuracy was significantly higher in the EF condition than in the IF condition. In both EF and IF conditions, MEP amplitude in the TA muscle, but not the SOL muscle, was significantly higher immediately before TA muscle onset (− 100, − 50, and 0 ms) compared to the control. In particular, the MEP increment in the TA muscle before TA muscle onset (− 50 and 0 ms) was significantly larger in the EF condition than in the IF condition. Our findings provide the first evidence for the modulation of corticospinal excitability in APA by changing attentional focus.

The effect of attentional focus instructions on performance and technique in a complex open skill

ABSTRACT External focus of attention has been shown to promote more automatic motor control, yielding better performance and more efficient technique, than an internal focus. However, most research has used closed-skill tasks in novices. The extent to which the reported pattern of findings generalises to more complex, time-constrained tasks requires further investigation. In this study, we investigated the effect of attentional focus instructions on performance and technique in an open-skill task in skilled performers. Thirteen skilled cricket batters batted from a ball projector in four conditions, receiving instructions to focus on the movement of their hands (internal focus), the movement of their bat (proximal external focus), the flight of the ball (distal external focus), or no instruction (control). Performance and technique were measured by quality of bat-ball contacts and step length/knee flexion, respectively, whilst playing straight drives. Compared to external focus and control conditions, focusing internally yielded significantly worse batting performance and shorter step lengths, with the largest effects observed between internal and distal external focus conditions. Quality of bat-ball contact data suggested that participants’ ability to protect the wicket (as evidenced by more miss/edge shots) was more negatively affected by focusing internally than their ability to play shots to score runs (as evidenced by fewer good bat-ball contacts). Findings suggest that, for skilled performance of open-skill tasks, a distal external focus yields more effective performance and technique compared with focusing internally. Findings highlight the need for further research on attentional focus effects between different skills within specific sports. Highlights A distal external focus of attention enhances performance and technique of skilled cricket batters compared with an internal focus. Providing skilled batters with no instructions yields similar performance benefits to distal external focus instructions. Focusing internally differentially negatively affects skilled cricket batters depending on the strategic intention of the shot being played (e.g. protecting the wicket vs attempting to score runs).

The Effect of Large Visual Illusion and External Focus of Attention on Gaze Behavior and Learning of Dart Throw Skill

Research has shown that large visual illusions and an external focus of attention can improve novice’s motor learning. However, the combined effects of these approaches and the underlying mechanisms have yet to be studied. Therefore, the present study examined the effects of a large visual illusion and an external focus on the learning of a dart throwing task in novices and measured the perceptual mechanisms underpinning learning using quiet eye. Forty novice participants were randomly divided into four groups: large visual illusion, external focus of attention, combined large visual illusion and external focus of attention, and control group. The study consisted of a pretest, a practice phase, an immediate retention test, a 24-hr retention test, and a transfer test. Results revealed that all groups increased throwing accuracy and quiet eye duration from pretest to immediate retention. In the immediate retention, 24-hr retention, and transfer test, large visual illusion had greater accuracy and longer quiet eye duration than the control group. In addition, there were no significant differences between the visual illusion and external focus groups for throwing accuracy and quiet eye duration. The findings suggest that combining large visual illusion and external focus can independently improve motor learning but combining these manipulations does not have additive benefits.

An external focus of attention enhances table tennis backhand stroke accuracy in low-skilled players.

The aim of the study was to determine the impact of internal and external (proximal and distal) attentional focus on table tennis backhand stroke accuracy in low-skilled players. Fifty-one undergraduate physical education (PE) students were randomly assigned to 3 groups: Group G1 (IF) was instructed to focus on the hand holding the paddle, Group G2 (EFP) was instructed to focus on the ball, while Group G3 (EFD) was instructed to focus on targets marked on the tennis table. The experimental groups followed identical instructions except for the instruction about the focus of attention. Participants were asked to score as many points as possible by hitting the ball inside the three smallest targets marked on the tennis table. They were required to do so using a backhand stroke. The practice session consisted of 45 trials in three blocks of backhand (15 trials at each target). A special scoring system was used to determine the accuracy of the strokes. One of the most important findings from the current research was that groups with an external focus of attention revealed significant improvements in accuracy in the post-test, while the group with an internal focus of attention achieved low training effects. No significant difference was observed between G2 (EFP) and G3 (EFD) in the delayed retention test, which indicates that proximal and distal attentional focus had similar effects on table tennis backhand stroke accuracy in low-skilled players.

Immediate Effect of Self-Modelling with Internal Versus External Focus of Attention on Teaching/Learning Gymnastics Motor-Skills

The aim of this study was to identify the immediate effect of self-modelling with different focus of attention strategies (i.e., internal vs. external) on the teaching/learning of gymnastics motor-skills. Fifty-nine non-gymnast students participated in this study and were divided into three groups (i.e., an external focus group (EF), an internal focus group (IF), and a control group (CG)). Each participant's performance of the back dismount in the parallel bars was assessed before the experiment (i.e., base-score), and each participant was asked to provide a self-evaluation of their performance and their efficiency percentage. Afterwards, participants received a specific learning session (i.e., self-modelling with external focus, self-modelling with internal focus, or traditional learning with verbal instruction) and performed the back dismount in the parallel bars again immediately after (i.e., final score). Four international judges evaluated performance of our participants. The results showed that the EF and IF outperformed the CG in the final score. Importantly, a significant difference between the base and the final score was observed in the EF and IF, but not in the CG. In addition, the EF showed the highest percentage of improvement (Δ-score) and self-estimation scores compared to the two other groups. In conclusion, this study supports the adoption of external focus of attention for teaching/learning gymnastics motor-skills.

Sequential focus of attention instructions influenced motor performance of volleyball setting despite direction of focus but dependent on motor expertise of the player

ABSTRACTPrevious studies have shown the advantage of external over internal focus of attention (FOA) for motor learning and performance. However, such a FOA effect is inconsistent when factors such as motor expertise, individual preference, and performance measurement are considered. For complex motor skills like volleyball setting, sequential FOA instructions (S-FOA) are often given to facilitate skill acquisition and performance, but it remains unknown whether internal and external FOA instructions would impact motor performance of skilled and novice players differently. Thirty-two novice (n = 16) and skilled (n = 16) female volleyball players were asked to perform a simulated volleyball setting task without (control) and with S-FOA (internal or external). Both movement outcomes and inter-joint coordination of flexion and extension were analysed using linear models and time-series analysis. The results supported previous literature on motor expertise showing that skilled players outperformed novice players with superior movement outcomes due to their ability to maintain an intermediate coordination pattern and functional variability of inter-joint coordination prior to ball contact. Despite direction of focus, S-FOA degraded the mean setting accuracy of skilled players without impacting their mean inter-joint coordination pattern and it also failed to influence the performance of novice players. Although S-FOA failed to impact the mean inter-joint coordination patterns of all participants, they allowed individuals to develop idiosyncratic coordination patterns for setting. S-FOA significantly reduced the variability of inter-joint coordination before and after ball contact for all players, however, it was considered detrimental for skilled players but beneficial for novice players.HighlightsSuperior setting performance is associated with the ability to adopt an intermediate inter-joint coordination pattern with a functional variability prior to ball contactDespite direction of focus, the effects of sequential focus of attention (SFOA) instructions on inter-joint coordination pattern of players are idiosyncraticThe SFOA-induced reduction of variability of inter-joint coordination before and after ball contact is considered detrimental for skilled players but beneficial for novice players

A distal external focus of attention facilitates compensatory coordination of body parts

ABSTRACT Many studies have shown that focusing on an intended movement effect that is farther away from the body (distal external focus) results in performance benefits relative to focusing on an effect that is closer to the body (proximal external focus) or focusing on the body itself (internal focus) (see, Chua, Jimenez-Diaz, Lewthwaite, Kim & Wulf, 2021). Furthermore, the advantages of a distal external focus seem to be particularly pronounced in skilled performers (Singh & Wulf, 2020). The present study examined whether such benefits of more distal attentional focus may be associated with enhanced functional variability. Volleyball players (n = 20) performed 60 overhand volleyball serves to a target. Using a within-participants design, the effects of a distal external focus (bullseye), proximal external focus (ball) and an internal focus (hand) were compared. The distal focus condition resulted in significantly higher accuracy scores than did the proximal and internal focus conditions. In addition, uncontrolled manifold analysis showed that functional variability (as measured by the index of synergy) was greatest in the distal focus condition. These findings suggest that a distal external focus on the task goal may enhance movement outcomes by optimising compensatory coordination of body parts.

The Effect of the Combination of Visual Illusion and External Focus of Attention on Learning Dart Throwing Skill in Novices

Background: Although studies has shown the effectiveness of large visual illusion and external focus of attention on motor learning in novices, there is no research evidence about the combined effect of these variables. This study aimed to investigate the combined effect of large visual illusion and external focus of attention on learning dart throwing skill in novices. Materials and Methods: In the present study, 40 novice participants aged 18-40 voluntarily participated and were randomly divided into four groups; large visual illusion, external focus of attention, combined, and control group. The study consisted of a pre-test, practice phase, post-test, and retention test. Data analysis was performed by repeated measures analysis of variance in SPSS software version 20 (P≤0.05). Results: The results of the analysis of the variance test for the acquisition of dart throwing performance showed that all three effects of stage, group, and interaction were significant (P≤0.05). Accuracy increased in all groups, from pre-test to post-test. In the post-test and retention test, the experimental groups were more accurate than the control group; however, no significant difference was observed between them (P>0.05). Conclusion: External focus instructions and manipulations that enhance more perceptual processes may lead to optimal performance and learning. The findings of the present study suggest that although combining large visual illusion and external focus can independently improve motor learning, the combination of these manipulations has no additive benefits.

Effects of attentional focus and cognitive load on novice dart throwing: Evidence from quiet eye duration and pupillary responses

The purpose of the present study was to investigate the effects of attentional focus and cognitive-load on motor performance, quiet-eye-duration, and pupil dilation. 18 participants completed a dart throwing task under four conditions, internal or external focus with high or low cognitive-load. Cognitive-load was created by a secondary tone detection task. During each trial participants pupil size and eye movements were recorded along with accuracy data of the dart throw. Results revealed that decreased cognitive-load increased accuracy while high load increased pupil size (p's < 0.05). An external focus resulted in the greatest accuracy while an external focus with high cognitive-load resulted in the longest quiet-eye-durations (p's < 0.05). Based on these findings an increase in pupil size is related to greater cognitive-load but doesn't explain the improvement in task performance. Likewise, an external focus of attention improved performance but was not strongly related to quiet-eye-duration. Results are further discussed in the article.

The effects of attentional focus on visuomotor control during observational learning in children with autism spectrum disorder

BackgroundResearch has shown that adopting an external focus of attention facilitates both performance and learning. Recent research observed a benefit of adopting an external focus while viewing a modeled behavior. The current study investigated motor performance in children with autism following attentional focus cues while viewing demonstrations of an overhand throw. Eye tracking was used to investigate visual search strategies and attentional adherence. Method24 children with autism, aged 7–10, were randomly placed in internal or external modeling groups. 10-trial pre-test was performed to measure throwing accuracy and quiet-eye duration (QED). Children then observed a model performing the overhand throw while eye movements were recorded, followed by a 10-trial post-test. ResultsGroups improved accuracy (p < .001) and increased QED (p < .001) from pre- to post-test. The external modeling group had greater accuracy (p < .01) and longer QED (p < .001) than the internal modeling group during post-testing. ConclusionsNot only did children with autism significantly improve performance with the attentional focus manipulation, but the adoption of an external focus led to longer quiet eye durations which potentially explains the pattern of performance findings. These results with practical applications are discussed in the paper.

Age and attentional focus instructions effects on postural and supra-postural tasks among older adults with mild cognitive impairments.

The purpose of this study was to investigate the age and attentional focus instruction effects on the postural and supra-postural tasks among older adults with mild cognitive impairments. Forty healthy adults (mean age of 48.01 ± 5.45years) and 40 older adults with mild cognitive impairments (mean age of 69.87 ± 4.28years) were selected as participants. They were randomly divided into eight groups receiving internal and external attentional focus instructions for postural and supra-postural tasks. The postural status was evaluated by measuring the COP sway velocity with the Master Balance System. The results showed that in both phases of acquisition and retention, the main effect of the attentional focus type was significant (P < 0.05). The group's postural control with external attentional instructions was better than the group's postural control with internal attentional instructions. Furthermore, the CI elderly gained benefit from the guidelines of attentional focus. Results showed that the task type was not significant in the acquisition phase. However, in the retention phase, the main effect of the attentional focus type was significant. The groups' postural function with the supra-postural task was better than the groups with the postural task. Furthermore, the older adults showed a better postural function in the supra-postural task than in the postural task. Our results showed that the ability to allocate resources of attention may decrease with CI. These findings suggest that considering the effect of the supra-postural tasks' manipulation on postural control, it is possible to improve balance by designing training programs for directing supra-postural tasks. The findings of the present study can be a guide for educators and therapists. They can increase the balance of the patients by considering the dysfunction and the type of attentional guidelines to prevent them from falling and performing a dual task.

Comparing the Effects of Differential Learning, Self-Controlled Feedback, and External Focus of Attention Training on Biomechanical Risk Factors of Anterior Cruciate Ligament (ACL) in Athletes: A Randomized Controlled Trial.

The current study aimed to compare the possible effects of differential learning strategy, self-controlled feedback, and external focus of attention on kinetic and kinematic risk factors of anterior cruciate ligament (ACL) injury in athletes. Forty-eight male athletes from three sports of handball, volleyball and basketball were selected for this study and were randomly divided into four groups: differential learning (n = 12), self-control feedback (n = 12), external focus (n = 12), and control (n = 12) group. All groups followed the intervention for eight weeks with three sessions per week. Data were analyzed by means of 4 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of p ≤ 0.05. A significant group × time interaction and the main effect of time was found for most kinetic and kinematic variables. The main effect of the group was significant only at the knee abduction angle. Differential learning and external focus of attention methods positively reduced the kinetic and kinematic variables that are considered risk factors for ACL injury. However, the effect sizes (Cohen’s d) for the changes in most of the variables were larger for the differential learning group. Tailoring the boundary conditions that are based on the manipulations created in the exercise through variability and variety of movements associated with differential learning methods rather than repeating movements could reduce the risk of ACL injury.

The impact of external and internal focus of attention on visual dependence and EEG alpha oscillations during postural control

BackgroundThe ability to maintain upright posture requires successful integration of multiple sensory inputs (visual, vestibular, and somatosensory). When one or more sensory systems become unreliable, the postural control system must “down-weight” (or reduce the influence of) those senses and rely on other senses to maintain postural stability. As individuals age, their ability to successfully reweight sensory inputs diminishes, leading to increased fall risk. The present study investigates whether manipulating attentional focus can improve the ability to prioritize different sensory inputs for postural control.MethodsForty-two healthy adults stood on a balance board while wearing a virtual reality (VR) head-mounted display. The VR environment created a multisensory conflict amongst the different sensory signals as participants were tasked with maintaining postural stability on the balance board. Postural sway and scalp electroencephalography (EEG) were measured to assess visual weighting and cortical activity changes. Participants were randomized into groups that received different instructions on where to focus their attention during the balance task.ResultsFollowing the instructions to direct attention toward the movement of the board (external focus group) was associated with lower visual weighting and better balance performance than when not given any instructions on attentional focus (control group). Following the instructions to direct attention towards movement of the feet (internal focus group) did not lead to any changes in visual weighting or balance performance. Both external and internal focus groups exhibited increased EEG alpha power (8–13 Hz) activity over the occipital cortex as compared to the control group.ConclusionsCurrent results suggest that directing one’s attention externally, away from one’s body, may optimize sensory integration for postural control when visual inputs are incongruent with somatosensory and vestibular inputs. Current findings may be helpful for clinicians and researchers in developing strategies to improve sensorimotor mechanisms for balance.

Direction of attentional focus in prosthetic training: Current practice and potential for improving motor learning in individuals with lower limb loss.

Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting. Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age = 50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience = 10 years, range = 4-21 years) during prosthetic training were recorded. Recordings were analyzed to categorize the direction of attentional focus embedded in the instructional and feedback statements as internal, external, mixed, or unfocused. We also explored whether LLP users' age, time since amputation, and perceived mobility were associated with the proportion of attentional focus statements they received. We recorded a total of 20 training sessions, yielding 904 statements of instruction from 338 minutes of training. Overall, one verbal interaction occurred every 22.1 seconds. Among the statements, 64% were internal, 9% external, 3% mixed, and 25% unfocused. Regression analysis revealed that female, older, and higher functioning LLP users were significantly more likely to receive internally-focused instructions (p = 0.006, 0.035, and 0.024, respectively). Our results demonstrated that verbal instructions and feedback are frequently provided to LLP users during prosthetic training. Most verbal interactions are focused internally on the LLP users' body movements and not externally on the movement effects. While more research is needed to explore how motor learning principles may be applied to improve LLP user outcomes, clinicians should consider adopting the best available scientific evidence during treatment. Overreliance on internally-focused instructions as observed in the current study may hinder prosthetic skill learning.

Examining the Mechanisms of Internal and External Focus of Attention With Donders’ Subtractive Method

The goal of the current study was to measure the processing demands on the stages of information processing with internal and external foci of attention. Participants completed simple and two-choice reaction time tasks with internal and external foci of attention. Donders' subtraction method was used to isolate the cumulative duration of stages unique to simple and choice reaction time tasks. Mean reaction time was comparable with internal and external foci of attention in simple and two-choice reaction time tasks. These results suggest that processing demands were comparable with internal and external foci of attention. We hypothesize that there was not a processing advantage for an external focus in simple reaction time because the required movements had low movement complexity.

Effects of attention focus instructions on amateur piano performance

Detriments to performance under pressure are common in many performance settings, from public speaking to skilled sports or music performances. In the last few decades, sports scientists have suggested that the quality and accuracy of movements can depend on what the performer attends to while executing the action, with an external focus of attention directed at the effects of the movement on the environment resulting in better performance than an internal focus, where attention is directed at the performer’s own body movements. Here we investigated the effects of attention focus instruction on the accuracy of piano performance. Amateur pianists were asked to practice a set piano piece for 7 days and then perform it to the experimenter under different performance instructions (no instruction, internal focus, external focus). An external focus of attention resulted in more accurate performance compared to an internal focus instruction, as evaluated by the difference in the number of note pitch errors and note corrections between the two conditions. Importantly, the advantage of an external over internal focus did not depend on pianistic expertise in our sample. Our research supports the idea that an external attention focus can improve music performance and should be considered in music teaching practice.

A meta-analysis on immediate effects of attentional focus on motor tasks performance

ABSTRACT Directing the attentional focus towards intended movement effects could enhance individual performance. This meta-analysis examines the immediate effects of an instructed external (proximal/distal) and internal attentional focus on an experimental group and a control group on their performance. A systematic review was done following the PRISMA guidelines. A total of 3833 reports were scanned. Of these, 83 were included in the systematic review, and 61 studies were included into the meta-analysis. The meta-analysis was additionally split into the original categories, which included the instructions as mentioned in the paper, and the adapted classifications, for which the instructions were reclassified based on the definition by [Wulf, G. (2013). Attentional focus and motor learning: A review of 15 years. International Review of sport and Exercise psychology, 6(1), 77–104. doii:10.1080/1750984X.2012.723728 and McNevin, N. H., Shea, C. H., & Wulf, G. (2003). Increasing the distance of an external focus of attention enhances learning. Psychological Research, 67(1), 22–29. doii:10.1007/s00426-002-0093-6]. In line with the constrained-action hypothesis, an external attentional focus instruction enhanced the immediate performance compared to an internal attentional focus instruction (SMDadapted = 0.24) and the control group (SMDadapted SMD = 0.31). Also, consistent with the constrained-action hypothesis, distal external attentional focus instructions showed performance-enhancing effects compared to proximal external attentional focus instructions (SMDadapted = 0.23). However, most comparisons showed moderate to substantial heterogeneity and wide prediction intervals. Therefore, the results cannot be generalized for all tasks and skill levels.