Acute and long-term effects of attentional focus strategies on muscular strength: a meta-analysis

This review aimed to perform a meta-analysis examining the following: (a) acute effects of adopting an internal focus vs. external focus of attention on muscular strength; and (b) long-term effects of adopting an internal focus vs. external focus of attention during resistance training on gains in muscular strength. We searched through five databases to find eligible studies. Random-effects meta-analyses of standardized mean differences were conducted to analyze the data. Ten studies were included. In the meta-analysis for the acute effects, there was a significant positive effect of external focus on muscular strength (standardized mean difference: 0.34; 95% confidence interval: 0.22, 0.46). In the meta-analysis for the long-term effects, there was no significant difference between training with an internal focus and external focus on muscular strength gains (standardized mean difference: 0.32; 95% confidence interval: –0.08, 0.73). In the subgroup analysis for lower-body exercises, we found a significant positive effect of training with an external focus on muscular strength gains (standardized mean difference: 0.47; 95% confidence interval: 0.07, 0.87). In summary, our findings indicate an acute increase in muscular strength when utilizing an external focus of attention. When applied over the long-term, using an external focus of attention may also enhance resistance training-induced gains in lower-body muscular strength