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.
Background: To use the meta-analytic approach to assess the effectiveness of different types of movement programs on motor competence (MC) in participants of all ages. Methods: Studies were retrieved by searching 13 databases and included when criteria were met. Studies were selected, and data were extracted by 2 authors. Random effects models using the standardized mean difference effect size (ES) were used to pool results. Risk of bias, heterogeneity, and inconsistency were examined. Results: Thirty-six studies met the inclusion criteria. A total of 374 ESs were calculated and partitioned into 4 groups (motor intervention, free play, physical education classes, and control group). Statistically significant improvements in MC were observed for the motor intervention (ES = 1.50; 95% confidence interval [CI], 1.18 to 1.82; n = 36), as well as for free play (ES = 0.33; 95% CI, 0.09 to 0.57; n = 5), physical education classes (ES = 0.52; 95% CI, 0.08 to 0.97; n = 15), and smaller statistically significant differences in MC were observed for the control groups (ES = 0.16; 95% CI, 0.01 to 0.31; n = 6). Conclusions: All 4 groups analyzed improved MC in children, adolescents, and young adults. However, motor interventions were superior to all other groups for improving MC.
Purpose: The present study was to use the aggregate data meta-analytic approach to examine the effects of attentional focus during balancing tasks in motor learning. Method: A literature search was conducted based on five electronic database searches, cross-referencing and expert review. Studies included randomized trials of external (EF) versus internal focus (IF). Risk of bias was assessed using a self-developed instrument. Random effects models using the standardized mean difference effect size (ES) were used to pooled results. Heterogeneity was examined using the Q statistic and inconsistency using I 2 . Results: Of 790 studies screened, 16 representing 541 males and females and up to 17 ES met the inclusion criteria. Analyses indicated that the EF groups outperformed the IF groups for acquisition phase (ES= 0.48, n= 16; CI95%= 0.07 to 0.90, Q= 68.7, I 2 = 78.2%), retention (ES= 0.44, n= 17, CI95%= 0.14 to 0.74; Q= 26.1, I 2 = 38.6%), and transfer (ES= 1.41, n= 4, CI95%= 1.00 to 1.82, Q= 22, I 2 = 0%). Conclusion: The overall results suggest that EF results in better balance learning when compared to IF.
The objective of this systematic review and meta-analysis is to compare the effect of physical activity only with that of physical activity plus diet interventions on body mass index (BMI) in Latin American children and adolescents. We searched the Medline, Embase, Scopus, Web of Science, and Scielo databases from their inception until March 2020, including studies examining the effect of physical activity or physical activity plus diet interventions on BMI in children and adolescents and based on data from intervention studies. The DerSimonian and Laird method was used to compute a pooled standardized mean difference for BMI in terms of effect size (ES) and respective 95% confidence intervals (CIs). Eighteen studies were included. Analyses were performed based on intervention (four studies were included for physical activity only and four studies were included for physical activity plus diet). In the analysis of physical activity only versus control, there was no effect on BMI (ES = 0.00; 95% CI −0.17–0.17, I2 = 0.0%; p = 0.443). In the analysis of physical activity plus diet versus control, there was a decrease in BMI in favour of the intervention group (ES = −0.28; 95% CI −0.42–−0.14, I2 = 74.5%; p = 0.001). When ES was estimated considering only the effect in intervention groups, there was no evidence of a decrease in BMI (ES = −0.17; 95% CI −0.44–0.11, I2 = 84.5%; p < 0.001) for physical activity only (eight studies). However, there was a statistically significant decrease in BMI (ES = −0.30; 95% CI −0.50–0.11, I2 = 95.8%; p < 0.001) for physical activity plus diet (ten studies). Some limitations of this review could compromise our results, but the main limitation that should be stated is the quality of the studies (mainly medium/moderate), especially as physical activity and diet interventions cannot be blinded, compromising the quality of these studies. In summary, this meta-analysis offers evidence that physical activity plus diet interventions produced a reduction in BMI in Latin American children and adolescents, but physical activity only interventions did not.
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