An external focus of attention enhances balance learning in older adults

Studies with young adults have shown that an external focus of attention (i.e., on the movement effect) results in more effective motor learning and greater automaticity than an internal focus (i.e., on one's own body movements). The present study examined whether instructions inducing an external versus internal attentional focus would differentially affect the learning of a balance task in 32 older adults (24 females and 8 males, mean age: 69.4 years), divided equally, by number and gender, into two groups. The task required participants to stand on a balance platform (stabilometer) tilting to the left and right, and to try to keep the platform as close to horizontal as possible during each 30-s trial. The external focus group was instructed to concentrate on keeping markers on the platform horizontal, while the internal focus group was instructed to concentrate on keeping their feet horizontal. The dependent variable was time in balance (i.e., platform movements within ±5°). Participants performed 10 practice trials on day 1, with focus reminders given before each trial. Learning was assessed by a retention test, consisting of five trials without instructions, performed 1 day later. The external focus group outperformed the internal focus group in retention [F(4, 120) = 3.46, p = .01]. The results demonstrate that the learning benefits of an external attentional focus are generalizable to older learners.