Effects of external focus of attention on balance: a short review.

[Purpose] The present study reviewed studies that examined the effects of attentional focus on balance. [Methods] Keywords such as "attentional", "focus", and "balance" were used to find relevant research papers in PubMed (www.ncbi.nlm.nih.gov/pubmed). Forty-five papers were found, and 18 of them were used for this study, excluding review papers and papers irrelevant to the topic of this study. [Results] Among the papers used for the review, the number of papers in which external focus produced effective outcomes was 15 (83.3%). The number of papers in which both external and internal focus produced effective outcomes was 2 (11.1%). The number of paper in which no instruction about attentional focus was effective was 1 (5.5%), and the number of papers in which internal focus was effective was zero. [Conclusion] This short review suggests clinical implications about how physical therapists can use attentional focus for balance rehabilitation of patients. Instructions about external focus of attention can generally be useful as a method to improve posture and balance control. Furthermore, the present reviews indicates that external focus of attention would be more useful in a rehabilitation stage in which the difficulty level of balance performance is gradually increased.