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.