An external focus of attention enhances balance learning in older adults

Chiviacowsky, Suzete; Wulf, Gabriele; Wally, Raquel

doi:10.1016/j.gaitpost.2010.08.004

Cited by 141 publications

(123 citation statements)

References 23 publications

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“…postural sway). For example, reductions in postural sway can be observed under external focus conditions in young and older adults (Chiviacowsky, Wulf and Wally 2010;McNevin, Weir and Quinn 2013;Wulf et al 2004). In the present study, we specifically avoided instructions of internal focus of attention by asking participants to "minimise movements of the grocery bag".…”

Section: Resultsmentioning

confidence: 99%

Effects of external loads on postural sway during quiet stance in adults aged 20–80 years

et al. 2018

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Section: Resultsmentioning

confidence: 99%

Effects of external loads on postural sway during quiet stance in adults aged 20–80 years

et al. 2018

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“…Indeed, the evidence to support the benefits of an external focus of attention among healthy populations is compelling. 3,10,12,13,37,51,52 Although many of these studies investigated discrete object manipulation tasks (eg, hitting a ball), some demonstrated the relative benefits of an external focus of attention during performance of whole-body tasks such as long jumping 16 or treadmill running. 17 These findings suggest that the type of motor task being practiced is not necessarily important, and the findings, therefore, may be equally applicable to tasks such as gait rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Internal and External Focus of Attention During Gait Re-Education: An Observational Study of Physical Therapist Practice in Stroke Rehabilitation

2013

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Background Focus of attention is known to play an important role in motor skill learning, yet little is known about how attention is directed within the context of stroke rehabilitation. Objective The aims of this study were: (1) to identify physical therapists' use of internal and external focus of attention during gait rehabilitation for individuals with hemiplegia following stroke and (2) to use the findings to design an experimental study examining the impact of focus of attention on learning poststroke. Design The study design involved direct nonparticipation observation of physical therapy treatment sessions. Methods Eight physical therapy treatment sessions, in which gait rehabilitation was taking place, were video recorded. Patients were aged between 36 and 85 years, and ranged from 7 to 216 days poststroke; physical therapists had between 3 and 12 years of experience in stroke rehabilitation. Data analysis took 2 forms: (1) clear definitions of internal and external focus of attention were agreed on via a consensus group and used to develop an analysis matrix through which incidences of instruction and feedback were identified, categorized, and counted; and (2) verbal dialogue was transcribed verbatim and transcripts were thematically analyzed to provide a detailed description of how instructions and feedback were used, illustrated by examples. Results The use of instructions and feedback (internal and external focus) was high; an average of one verbal instruction or feedback statement was delivered every 14 seconds. Sixty-seven percent of the statements were internally focused, 22% were externally focused, and 11% were of mixed focus. Unfocused statements (eg, “good”) also were used regularly. Patients were frequently encouraged to “think about” their performance. Limitations Observational data collection methods may result in changes in the behavior of those observed, which is a potential source of bias. The small sample size also was a limitation of the study. Conclusion Physical therapists frequently encouraged patients to be aware of their movements and their performance (internal focus). This approach may reduce automaticity and hinder learning and retention.

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“…Balance has been shown to be enhanced when the performer's attention is directed externally to minimizing movements of a balance platform (or markers attached to it) as compared to being directed internally to movements of their feet (Chiviacowsky, Wulf, & Wally, 2010;Jackson & Holmes, 2011;McNevin, Shea, & Wulf, 2003;Shea & Wulf, 1999;Wulf, Weigelt, Poulter, & McNevin, 2003). Other tasks have included standing still on other movable platforms (Laufer, Rotem-Lehrer, Ronen, Khayutin, & Rozenberg, 2007; or an inflated rubber disk (Wulf, Landers, Lewthwaite, & Töllner, 2009), or riding a Pedalo (Totsika & Wulf, 2003).…”

Section: Balancementioning

confidence: 99%

Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning

2016

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Effective motor performance is important for surviving and thriving, and skilled movement is critical in many activities. Much theorizing over the past few decades has focused on how certain practice conditions affect the processing of task-related information to affect learning. Yet, existing theoretical perspectives do not accommodate significant recent lines of evidence demonstrating motivational and attentional effects on performance and learning. These include research on (a) conditions that enhance expectancies for future performance, (b) variables that influence learners' autonomy, and (c) an external focus of attention on the intended movement effect. We propose the OPTIMAL (Optimizing Performance through Intrinsic Motivation and Attention for Learning) theory of motor learning. We suggest that motivational and attentional factors contribute to performance and learning by strengthening the coupling of goals to actions. We provide explanations for the performance and learning advantages of these variables on psychological and neuroscientific grounds. We describe a plausible mechanism for expectancy effects rooted in responses of dopamine to the anticipation of positive experience and temporally associated with skill practice. Learner autonomy acts perhaps largely through an enhanced expectancy pathway. Furthermore, we consider the influence of an external focus for the establishment of efficient functional connections across brain networks that subserve skilled movement. We speculate that enhanced expectancies and an external focus propel performers' cognitive and motor systems in productive "forward" directions and prevent "backsliding" into self-and non-task focused states. Expected success presumably breeds further success and helps consolidate memories. We discuss practical implications and future research directions.Keywords Motivation . Attentional focus . Self-efficacy . Positive affect . Dopamine . Motor performance Skilled movement is fundamental to surviving and thriving in the world and the basis as well for many of the highest human endeavors and cultural achievements, from sport to art to music. How people learn and relearn movement skills has been addressed from a number of disparate scientific perspectives and levels of analysis, including behavioral, social cognitive, neurophysiological, and neurocomputational. In part, differences in assumptions, scientific terminology and philosophy, as well as methodological approaches have made scholarly rapprochement challenging, but we see the end goal of optimizing motor learning as important. We suggest that it may be valuable to bring recent insights from various approaches together to identify a coherent way forward that can result in optimized learning from humans' earliest encounters with new motor skills to the lifelong development of motoric expertise.It is typically considered time to look afresh at dominant theories in a field when the accumulating evidence suggests that old frameworks cannot account for substantial new insights an...

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An external focus of attention enhances balance learning in older adults

Cited by 141 publications

References 23 publications

Effects of external loads on postural sway during quiet stance in adults aged 20–80 years

Effects of external loads on postural sway during quiet stance in adults aged 20–80 years

Internal and External Focus of Attention During Gait Re-Education: An Observational Study of Physical Therapist Practice in Stroke Rehabilitation

Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning

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