External Focus Group Research Articles

The Effect of External Focus Versus Internal Focus Instruction on Jump-Landing Biomechanics in Healthy Females.

There are different ways to deliver external focus (EF) and internal focus (IF) instruction. Understanding each modality better will help to develop more effective interventions to reduce injury risk. To investigate the difference in landing biomechanics between participants who received EF and IF instruction and control participants. A secondary aim was to evaluate participant perceptions of focus of attention. Randomized controlled trial. Laboratory. Forty-one healthy women (EF: n = 14, 23.0 ± 2.9 years, 1.69 ± 0.07 m, 64.0 ± 6.8 kg; IF: n = 15, 22.9 ± 3.2 years, 1.66 ± 0.08 m, 66.2 ± 12.4 kg; control: n = 12, 21.1 ± 2.9 years, 1.67 ± 0.11 m, 74.3 ± 15.1 kg). Participants scoring greater than or equal to 5 on the Landing Error Scoring System were allocated into the EF, IF, or control group. Knee and hip flexion and abduction were collected pre- and postintervention during 5 drop vertical jumps. For the intervention, each group was provided separate instructions. In between the intervention jumps, participants answered, "What strategy were you focusing on when completing the previous jump-landing trials?" Postintervention minus preintervention change scores were calculated, and separate 1-way analysis of variance assessments were performed to determine differences in the dependent variables. Individuals in the EF group had a greater change in hip and knee flexion angles than individuals in the control group. There was no significant difference between the EF and IF groups for any variables. There were no significant differences in frontal plane variables. In the EF group, 71.4% aligned with the instructions given; in the IF group, 80% aligned; and in the control group, 50% aligned. External focus instruction may not produce immediate changes in movement compared with IF instruction. Hip and knee flexion were greater in the EF group than in the control group but was not better than that in the IF group. Clinicians should provide instructions to patients, but the mode of instruction may not be as critical to see positive biomechanical changes. Patients may not always focus on the instruction being given; therefore, the relationship between instruction and patient experience should be further explored.

An external focus promotes motor learning of an aiming task in individuals with hearing impairments.

Research has shown that external relative to internal focus (IF) instructions may improve motor performance as well as cognitive function (e.g., attentional stability and task-focus). The aim of the study was to examine the influence of attentional focus instructions on skill acquisition and learning of an aiming task in individuals with hearing impairments. The participants (N=39, Mage=17.87±1.88years) performed a bowling task with their dominant hand to knock down as many pins as possible. On day 1, they were randomly divided into three attentional focus groups; IF (focus on your throwing hand), external focus (EF) (focus on the pins), and control (no-focus) instructions. Each participant performed 36 trials, divided into 3 blocks of 12 trials. Attentional focus instructions were given before each block, with a brief reminder provided after each 3 trials. On day 2, retention and transfer (further distance) tests were performed. Results showed that while there were no significant differences between groups in the pre-test, the EF group outperformed both IF and control groups in retention and transfer tests. No significant difference was found between the control and IF. The findings suggest that the advantages of the external relative to the IF and no-focus instructions may generalize to individuals with hearing impairments.

External vs Internal Focus of Attention in Procedural Skills Learning: A Randomized Study.

The Optimizing Performance Through Intrinsic Motivation and Attention for Learning theory postulates that directing attention to the intended movement effect or outcome (external focus) is more effective than directing attention to the internal body motion or body part (internal focus). This study compared external vs internal focus of attention as novice students learned ultrasound-guided peripheral cannulation. The authors hypothesized that conditions promoting an external (vs internal) focus of attention would result in better performance on immediate and delayed (retention) testing. The authors conducted a randomized, experimental study from October 2022 to February 2023 comparing external and internal focus using ultrasound-guided peripheral venous cannulation followed by practice using an ultrasound training block. Undergraduate health science students performed 4 practice trials with instructions to focus on the needle tip (external focus) or their hands (internal focus), followed by an immediate assessment and a retention assessment 2 weeks later. The primary outcome was time to successful cannulation. Results were compared using Kaplan-Meier curves and parametric survival analysis regression (accelerated failure time) models. Seventy participants completed the immediate assessment. The external focus group completed successful cannulation a mean of 2.33 times faster (95% CI = 1.47, 3.67; P < .001) than those in the internal focus group (median time, 12.0 vs 29.5 seconds). Results also favored the external focus group during practice, with the external focus group successfully completing the task a mean of 1.83 times faster (95% CI = 1.04, 3.21; P = .04) than the internal focus group. In the retention assessment, the external focus group successfully completed the task a mean of 2.37 times faster (95% CI = 1.19, 4.74; P = .02) than the internal focus group. External focus of attention compared with internal focus of attention improves medical motor skill learning in novice learners.

From Research to Roach Traps: Practical Considerations for a Home-Based Asthma Program.

Home-based asthma interventions have a significant evidence base as an effective means to address moderate and severe breathing concerns triggered by home conditions. However, the literature lacks logistical and staffing considerations necessary to successfully implement such a program at a governmental level. This practice report and process evaluation outlines practical details and lessons learned during a healthy homes pilot, and how they were addressed in the design of a permanent program. To inform the creation of a permanent home-based asthma intervention at the Alexandria Health Department (AHD) (City of Alexandria, Virginia) and understand the tools and resources necessary for success. Participating households received a health and environmental assessment, followed by cleaning supplies, relevant education, and referrals to partners for services. AHD staff tracked challenges and insights at each step of the intervention. At the end of the pilot, staff worked with the community to identify solutions and design a permanent program. Although the pilot model was constructed based on existing case studies, technical assistance from national experts, and guidance documents, the team still experienced challenges around recruitment, staff support, home visit implementation, and impact evaluation. While pilots and existing literature can be instructive for identifying issues, work with residents and partners to develop a uniquely tailored community program was essential for practical success. Health departments developing new initiatives should consider both the staff and participant experience throughout the creation of administrative and programmatic processes. Testing out draft versions of these processes and materials using internal and external focus groups can identify potential bottlenecks and solutions upfront.

Flywheel Romanian Deadlift: Intra- and Inter-Day Kinetic and Kinematic Reliability of Four Inertial Loads Using Cluster Sets.

The primary aim of this study was to investigate the intra- and inter-day reliability of flywheel cluster set training in concentric power (CON), eccentric power (ECC), and ECC overload during the Romanian deadlift exercise (RDL). A secondary aim was to assess the acute effect of internal and external attentional focus instructions on mean power when performing the flywheel RDL. Fourteen collegiate male field sport athletes (age, 23.3 ± 3.7 years; mass, 80.8 ± 9.9 kg; height, 1.79 ± 0.06 m) were randomized into internal (n = 7) or external (n = 7) attentional focus groups and attended four testing sessions, with a between-session separation of 7 days. Sessions consisted of four cluster sets of fifteen repetitions "excluding momentum repetitions" (4 × (5 + 5 + 5)) using a specific inertial load (0.025, 0.050, 0.075, and 0.100 kg·m-2) for a given set in a randomized ascending or descending order. Cluster sets were separated by a 45 s intra-set rest period. Both instructional focus groups attained familiarization, although the time taken to achieve familiarization (outcome stability) differed between groups. The external instructional group attained familiarization post-session 2 (Cohen's d (ES), ES = 0.11-0.65) with little volatility between performance measures (CV% = 4.61-9.59). Additionally, the internal group reported inconsistencies among all inertial loads, reporting large differences in MP in the 0.100 kg·m-2 inertial load from day 2 to day 3 (ES = 1.22) and both 0.050 kg·m2 (p = 0.010) and 0.075 kg·m-2 (p = 0.016) between day 3 and day 4. The flywheel RDL cluster set approach is a reliable training modality for maintaining mean power output during cluster set repetitions.

Golf skill learning: An external focus of attention enhances performance and motivation

An external focus of attention has been shown to enhance the performance and learning of motor skills, relative to an internal focus (see Chua, Jimenez-Diaz, Lewthwaite, Kim, & Wulf, 2021). In the present study, we examined possible motivational consequences of learners’ experience of greater movement success with an external focus. Participants were asked to learn a golf pitch shot. In addition to measuring learning, we assessed self-efficacy, as well as positive and negative affect in groups that received external versus internal focus instructions. Furthermore, we examined the feasibility of providing several focus instructions in the same practice session as the learning of complex skills typically requires more than one instructional cue. The results showed that skill learning was enhanced by instructions that promoted external foci, as measured by golf shot accuracy on delayed retention and transfer tests. The external focus group also showed higher positive affect and reduced negative affect at the end of practice, and higher self-efficacy before retention testing, compared with the internal focus group. These findings provide support for several assumptions of the OPTIMAL theory (Wulf & Lewthwaite, 2016). From a practical perspective, they highlight the attentional and motivational benefits of an external focus.

Do attentional focus cues affect the type or number of explicit rules? Proof of concepts of the self-invoking trigger or explicit knowledge hypotheses

Internal focus has been shown to be detrimental to performance by disrupting the motor system, whereas external focus enhances performance by promoting automaticity. One hypothesis, which explains the underlying mechanism of the disruption of the motor system, proposes that internal focus affects the type of thoughts (explicit rules) by invoking self-conscious, evaluative thoughts (McKay et al., 2015). In contrast, another hypothesis proposes that internal focus increases the number of explicit rules, loading working memory (Poolton et al., 2006). To examine the competing hypotheses, neurotypical young adults (22.98 ± 4.46 years old, n = 20 males, n = 40 females) were assigned to one of three groups: external focus (n = 20), internal focus (n = 20), and control (n = 20) groups, and practiced a reciprocal aiming task for two days with retention/transfer tests. Between trials, participant’s thoughts were evaluated by an open-ended questionnaire. The type of explicit rules was analyzed using a chi-square test, and the number of explicit rules was analyzed using a mixed-effect Poisson regression. The results showed that external focus resulted in a greater proportion of explicit rules about the task and a lesser proportion of self-evaluative thoughts. The number of explicit rules did not differ between groups. Our results suggest that external focus may strengthen focus on task-relevant features, while internal focus moves people’s attention away from important features, potentially explaining why the motor system is disrupted by internal focus.

Intra- and Inter-Day Reliability of Inertial Loads with Cluster Sets When Performed during a Quarter Squat on a Flywheel Device.

The aims of this study were to (i) estimate the intra- and inter-day reliability of mean concentric (CON) and eccentric (ECC) power at different inertial loads during a flywheel quarter-squat using a cluster set approach and (ii) to determine the acute effect of internal and external attentional focus on mean power when performing the flywheel quarter squat. Twelve collegiate field sport male athletes (age 22.4 ± 3.2 years, weight 81.4 ± 10.3 kg, height 1.81 ± 0.06 m) attended four cluster set testing sessions separated by 7 days. Sessions consisted of 4 sets of 15 repetitions using 4 inertial loads (0.025, 0.050, 0.075, and 0.100 kg·m2). A cluster block consisted of 5 repetitions, including "momentum repetitions" (4 × 5 + 5 + 5). Mean power (MP), CON power, ECC power, and ECC overload were recorded for both internal and external attentional focus groups. The external instructional group attained familiarization after two flywheel sessions (ES = 0.03-0.15) with little volatility between performance measures (CV% = 3.39-9.22). The internal instructional group showed large differences in MP output from session 2 to session 3 for all loads (ES = 0.59-1.25). In conclusion, the flywheel cluster set approach is a reliable training modality for maintaining MP output during all repetitions.

Examining the effectiveness of focus of attention instructions on the learning of a badminton long serve in novice students: movement automaticity hypothesis

ABSTRACT The superiority of an external focus of attention in motor performance and learning has been confirmed in many studies. However, less research has been done on how well the focus of attention performs under various conditions, such as when performing a dual-task. Recent research also suggests a holistic focus may provide a similar benefit to motor learning and performance. The current study investigates how an internal, external, and holistic focus influences motor learning in single and dual-task conditions. Sixty adolescent girls aged 14–17 without previous experience in the badminton long serve were selected as a sample and participated in the study. Participants were divided randomly into four groups: internal focus (pay attention to the performer's arm), external focus (pay attention to the racket), holistic focus (pay attention to smooth movement), and control group (no attentional focus instructions). Badminton long serves were performed in the acquisition phase (5 sessions), three retention tests (after 48 h, after one week, after one month), transfer and dual-task (with cognitive task) tests were assessed with accuracy as a dependent variable. Both external and holistic focus groups served more accurately in the retention and transfer phase (including dual-task transfer). A holistic focus also enhanced performance throughout acquisition relative to a control group. A holistic and external focus can be used to enhance motor learning. This benefit may be due to enhanced movement automaticity. Practitioners should consider the use of both holistic and external focus cues when giving instructions.

A Modified Delphi Study to Improve Prehospital Mass Casualty Incident Response

Introduction:The Novel Integrated Toolkit for Enhanced Pre-Hospital Life Support and Triage in Challenging and Large Emergencies (NIGHTINGALE) project was awarded to a consortium to design an innovative toolkit featuring different technological solutions for prehospital mass casualty incident (MCI) response. Translational science (T) methodology was undertaken to develop evidence-based guidelines for MCI response.Method:The consortium was divided into three work groups (WGs) MCI Triage, Prehospital Life Support and Damage Control and Prehospital Processes. Each WG previously collected data through the project T1 scoping review stage to provide the foundation for the initial T2 modified Delphi draft statements to present to WG internal focus groups for content and NIGHTINGALE study objectives. Their refined statements proceeded to WG specific external focus groups for further editing to be clear and concise for the following modified Delphi consensus rounds. Final WG statements were presented to modified Delphi experts for their consensus using the STAT59 platform with instruction to rank each statement on a seven-point linear numeric scale, where 1 = disagree and 7 = agree. Consensus amongst experts was defined as a standard deviation ≤1.0.Results:After three modified Delphi rounds, 18 of 24 statements attained consensus by the MCI Triage experts, eight of 25 by the Prehospital and Life Support and Damage Control experts, and 23 of 28 by the Prehospital Processes experts.Conclusion:The three work groups will utilize consensus statements during the NIGHTINGALE project T3 phase to create evidence-based MCI response guidelines.

Unexpected lucidity in dementia: application of qualitative methods to develop an informant-reported lucidity measure

Objectives Unexpected lucidity is a phenomenon of scientific, clinical, and psychological relevance to health professionals, to those who experience it, and their relatives. This paper describes qualitative methods used to develop an informant-based measure of lucidity episodes. Methods The approach was refinement of the operationalization of the construct; review of seminal items, modification, and purification; and confirmation of the feasibility of reporting methodology. Modified focus groups were conducted with 20 staff and 10 family members using a web-based survey. Themes included reaction when hearing the term; words that come to mind; description of and first reaction to referenced or observed ‘lucidity’ events. Semi-structured cognitive interviews were conducted with 10 health professionals working with older adults with cognitive impairment. Data were extracted from Qualtrics or Microsoft 365 Word® for analysis using NVivo. Results Conceptual issues, as well as issues regarding comprehension, interpretation, clarity, semantics, and standardization of definitions derived from an external advisory board, focus groups and cognitive interviews informed items’ modification, and resulted in the final lucidity measure. Conclusions An obstacle to understanding the mechanisms and estimating the prevalence of lucid events among individuals with dementia and other neurological conditions is the scarcity of reliable and valid measures. The substantive and varied data gathered from multiple methods including the collaborative work of an External Advisory Board, modified focus groups with staff and family caregivers, and structured cognitive interviews with health professionals were central in creating the revised version of the lucidity measure.

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.

Effects of attentional focus and gaze instruction during observational learning of a basketball free-throw

Observational learning has long been used to instruct individuals on how to perform a novice motor skill. Recently, research has shown a benefit to instructing learners to focus externally when viewing a video model (Asadi, Aiken, Heidari, & Kochackpour, 2021). Research has also highlighted the effectiveness of modeling correct gaze behaviors when learning a cognitive task (Jarodzka, van Gog, Dorr, Scheiter, & Gerjets, 2013). The purpose of the present study was to investigate the effectiveness of combining these two modalities. 40 individuals with a mean age of 21.77 ± 1.40 performed a novel motor task where they were asked to either focus internally or externally, and were provided with traditional instruction or were provided with an experienced performer's gaze behaviors while viewing a video demonstration. It was observed that both the external focus groups and the gaze instructed groups performed a basketball free-throw more accurately and had longer periods of quiet eye than an internal focus or traditional verbal instruction (p's < 0.05). Eye tracking also allowed for the assessment of attentional focus adherence. Participants focused on the instructed cues significantly more than irrelevant task aspects or a different focus types (p's < 0.05). These results highlight the effectiveness of cuing a learner to focus externally during observational learning. It also highlights the usefulness of providing correct gaze behaviors when observing a model.

A Pilot Study on Attentional Focus in Prescribing Physical Exercise in Outpatients with Obesity.

This pilot study compared the effects of two attentional focus strategies on fitness parameters and body composition in outpatients with obesity. This was a randomized, controlled study that enrolled 94 obese individuals and allocated them into an internal focus group (IF) or an external focus group (EF) while performing six weeks of a home-based training program. The home-based exercise program was the same for both groups except for the instructions that shifted the attention to an external or an internal condition. At the beginning and after the intervention period, participants were assessed for functional performance using the Functional Movement Screen (FMS), body balance using the Modified Balance Error Scoring System (M-BESS) and muscular strength with the Handgrip Strength Test (HST) and the Five-Repetition Sit-To-Stand (FRSTS) test. Concerning body composition and anthropometric parameters, the body mass index (BMI) and fat mass percentage (FM%) were calculated. Significant improvements, main interactions and effects of time and groups were highlighted in the EF group as compared to the IF group in FMS (35% vs. 21%), M-BESS (42% vs. 18%), HST (13% vs. 7%) and FRSTS (23% vs. 12%) measures, while FM% (5%) and BMI (6% vs. 5%) showed a similar improvement overtime (p < 0.001). In conclusion, our findings provide initial evidence that a 6-week training program performed following external focus instruction is able to promote significant enhancements in movement efficiency, balance and muscular strength as compared to an internal focus cue. Fitness coaches and therapists might consider integrating a specific attentional focus strategy when designing rehabilitation programs in subjects with obesity.

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.

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.

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

External focus (attention to the movement effect) has been found effective in motor performance and learning. However, while some investigators have suggested that the effect of attentional focus varies with task difficulty, others reported external focus benefits regardless of difficulty. We hypothesized that attentional focus effects would vary with practice, due to changes in the individual's processing efficiency. We had three 20-person participant groups (external focus instructions, internal focus instructions, control) practice three difficulty levels of a Fitts reciprocal tapping task over two days. Participants in the external/internal focus groups were instructed to "mentally focus on moving the pen/your hand as fast and accurately as possible," while control participants were instructed to "mentally focus only on doing your best to achieve the task goal." We then analyzed the effect of attentional focus by task difficulty at the initial performance (the beginning of the practice) and after learning (the retention/transfer phase), using movement time (MT) and number of error taps (Err) as performance measures. The internal focus group made more errors than the control group only at the retention/transfer phase. We found no error differences between the external and internal focus groups, and there were no MT differences between any groups. Our primary hypothesis about the differential effect of attentional focus by practice was supported. The attentional focus effect on Err differed in the retention/transfer phase from the immediate phase, suggesting that practice mediated the attentional focus effect. We discuss how information theory may supplement understanding of attentional focus interventions in motor skill acquisition.

Attentional focus on learning fundamental movement skills in children

Several researchers studying focus of attention have concluded that the external focus is superior to the internal in learning motor skills in adults. However, there is limited research concerning the effect of different focus of attention on learning fundamental movement skills in kindergarten children. The present study aimed to compare the effectiveness of internal and external focus of attention on learning and transfer of a throwing skill in kindergarten children. Participants were 51 children (5-6 years), boys and girls, who were randomly selected and assigned into three groups: two experimental (internal and external focus respectively) and one control group. The movement form and the outcome of a throwing task were evaluated. It was found that both experimental groups improved over time, in both movement form and outcome. During the transfer test, the external focus group was better than the internal focus group in movement form; however, there were no differences in movement outcome. It is concluded that both the external or internal focus of attention improved over time the movement outcome and form of the throwing skill. Since the acquisition of sports skills requires the acquisition of fundamental motor skills, further research is needed to investigate the effect of the external or internal focus of attention on fundamental movement skills in kindergarten children.

The autonomy and focus of attention strategies under distraction: Frequency and sample entropy analyses in a dynamic balance task.

An external focus of attention has been shown to be effective in balance tasks. However, replication in applied settings is limited. The OPTIMAL theory proposes that a combination of autonomy and external focus increases focus to the task goal, and therefore more effective than external focus alone. However, research suggests that the combined effect is limited in discrete skills, and the increased focus effect is only reported by subjective assessment. The present study examined the effect of the combined strategy and its effect of "increased focus" compared to external focus and control groups under distraction. In experiment 1, participants (N=60) practiced eight 35s trials on a stabilometer followed by a 10min-delayed retention test and an auditory distraction transfer test. The combined group chose a tape color to place on a stabilometer and was told to "keep the tapes parallel to the floor," the external focus group was yoked with the combined group, and the control group was told to "do your best". Performance was measured in Root Mean Square Error (RMSE). The increased focus effect was examined by both subjective (distraction score, a question about participants' perceptions) and objective (Mean Power Frequency, MPF, Sample entropy, SampEn) methods. Although participants improved significantly (p<.05), group differences were not observed during retention (p's>0.05). An increased focus effect of the combined effect was not observed in any variables (p's>0.05). In experiment 2, the practice duration was extended to replicate previous study designs (i.e., 90s trials; 2days of practice; 24h retention test; the number of participants). Consistent with experiment 1, group differences were not evident in RMSE, SampEn, and MPF (p's>0.05). We suggest that autonomy may be required to be task-relevant, and simply telling to do best may be as useful as external focus or combined strategies in a continuous balance task. Further, the analysis showed that SampEn increased on Day 1 but decreased on Day 2, and MPF decreased within a session, but the average MPF increased by the day. Potential explanations and future directions when utilizing these metrics are discussed.