Effect of Attention Focus on Acquisition and Retention of Postural Control Following Ankle Sprain

Laufer Y, Rotem-Lehrer N, Ronen Z, Khayutin G, Rozenberg I. Effect of attention focus on acquisition and retention of postural control following ankle sprain. Objective: To examine the effect of attentional focus instructions and dynamic balance training on ankle sprain recovery. Design: Randomized controlled trial. Setting: Outpatient physical therapy department. Participants: Forty volunteers (age range, 19-33y) referred to treatment within 4 months after sustaining a grade 1 or 2 ankle sprain with no concurrent impairments. Participants were randomly allocated to 1 of 2 groups differing in training instructions. Intervention: Postural control training consisted of ten 20-second trials, performed on 3 consecutive days, at 2 stability levels of the Biodex Stability System (BSS). Training instructions directed the participants to either an internal or an external focus of attention. Assessments were conducted on the BSS pre- and post-training, and 48 hours after the last session (retention test). Main Outcome Measures: Overall stability as indicated by variance in platform displacement in all directions; anteroposterior (AP) variance of platform displacement; and mediolateral variance of platform displacement. Results: Increases in overall and AP stability were observed immediately following training in both groups and were maintained at the retention test. Interaction effect indicates greater improvement in the external-focus group. Conclusions: Our results suggest that external focus of attention is advantageous for the learning of a postural control task following an ankle injury.