Role of Attentional Focus in Shaping Motor Learning Processes Underlying Postural Control in Young Adults.

Abstract

Background: Attentional focus is a critical factor in motor learning, with external focus (EF) theorized to promote superior motor learning over internal focus (IF) by reducing conscious interference with automatic motor processes. Evidence in young adults using multi-session technology-based postural control training remains limited. Objective: To determine the differential effects of external versus internal attentional focus training on dynamic postural control learning in young adults over a 14-day period. Methods: Forty-five young adults (24  5 years) were randomly assigned to an EF group (Wii), IF group (BTrackS), or no-training control group (n = 15 per group) and completed five 45-minute training sessions. Motor learning was assessed via performance gain, saving, and offline change indices. Transfer of learning, dynamic postural control, and sensory interaction were assessed using the Ski Slalom, Go/No Go, Limits of Stability (LOS), and the modified clinical test of sensory interaction in balance (mCTSIB) tests, respectively. Results: Both training approaches promoted postural control learning and dynamic postural control improvement, while the control group showed no change. Learning improved through distinct trajectories; the IF group performance improved rapidly with stronger early offline gain (R2 = 0.76), while the EF group improved more gradually, with performance gain negatively associated with inter-session retention. Both approaches facilitated transfer of learning, with the IF group additionally generalizing to a cognitive motor task. Short-term training did not significantly alter sensory interaction. Conclusion: Attentional focus strategy shapes not whether postural control learning occurs, but how it progresses, changes at rest, and transfers. These findings highlight the underrecognized potential of IF training with direct implications for technology-based postural control training and rehabilitation practice.