Canan YUKSEL-HAJI
European Journal of Multidisciplinary Health Sciences - 2026;11(2):77-85
External-focus instructions (EFIs) may support more automatic motor control, but their effects appear to vary according to the task, performer and comparison condition. Evidence from balance studies has frequently been based on comparisons with internal-focus instructions, leaving uncertainty about whether an EFI provides an advantage over performing a task without a prescribed attentional focus. To examine the immediate effect of a single EFI on rocker-board balance performance in healthy adults and whether any response remained evident during a subsequent trial after withdrawal of the EFI. Twenty healthy adults were randomised to an EFI group or a no-prescribed-focus control group. Participants completed three 30-second rocker-board trials: a baseline trial, an intervention trial and a post-instruction trial. During the intervention trial, the EFI group was asked to minimise rocker-board movement, whereas the control group received no attentional-focus instruction. Centre-of-pressure displacement, right-ankle angular motion and rocker-board tilt were analysed using linear mixed-effects models. Between-group difference-in-change contrasts assessed the immediate response, the subsequent response relative to baseline and the change after withdrawal of the EFI. No significant group-by-trial interactions were identified for centre-of-pressure displacement, ankle movement variability or excursion, or rocker-board movement magnitude. The only significant contrast concerned the Trial 2-to-post-instruction change in mean rocker-board tilt; however, this outcome represented average board orientation rather than movement magnitude and was not accompanied by corresponding changes in the other outcomes. Confidence intervals around several estimates were wide. Within this exploratory sample, a single EFI did not yield a statistically distinguishable immediate response or clear evidence of short-term persistence relative to a no-prescribed-focus control condition. Given the small sample size and wide confidence intervals, these findings should be interpreted cautiously. Larger studies incorporating manipulation checks, repeated practice, and retention and transfer assessments are needed to obtain more precise estimates.
